Your Ultimate Lower Back Pain-Fighting Game Plan


First, the bad news about lower back pain: It happens frequently. If you're determined to run, lift, jump, swing, or shovel, you're probably going to strain something. "It's just how the body is," says Santhosh Thomas, a doctor of osteopathy and a specialist at the Cleveland Clinic's Center for Spine Health. "The good news is that most of the time the pain will go away within a week or so."

However serious your injury, though, you can speed up your recovery. We created a guide to help with that by enlisting various experts, including Dr. Thomas; Roger Chou, MD, an associate professor at Oregon Health and Science University and director of the clinical guidelines program for the American Pain Society; Cynthia Vaughan, a chiropractor in Austin, Texas; and Sue Bloom, a physical therapist in Needham, Massachusetts. And for more great advice, here's our exhaustive guide to becoming a better man.

Week 1

Days 1 to 3: When lower back pain hits, dial back any activity to prevent exacerbation. Ice for 15 minutes on, 45 minutes off, three times in a row. This will often knock out soreness completely. If you can't do the continuous cycle, ice two or three times a day for 72 hours. As long as the pain lessens, you're fine treating yourself for the first two weeks and taking an OTC pain reliever. If you experience extreme pain, bladder problems, persistent numbness, tingling in the legs, fever, or unexpected weight loss, see your primary-care physician immediately. If your doctor suspects you have a herniated disk, pinched nerve, tumor, fracture, infection, or other condition that may be causing back pain, he may recommend prescription opioids, muscle relaxants, a cortizone injection, an x-ray, an MRI or CT scan, a bone scan, or a nerve study.

Days 4 to 14: Start to do some stretching. Lie on your back and bring one knee up to your chest. Hold for 30 seconds and then switch legs. Do twice a day. Low-impact activities such as walking on an elliptical trainer or swimming, as well as massage or acupuncture, can also reduce pain.

Week 3

Day 15: If there's no discernible improvement, see your primary-care physician for possible prescription medication, such as a stronger form of lower back pain-relieving ibuprofen, possibly a muscle relaxant, or, if the pain is severe, an opioid that affects pain receptors. You may also want to consider rehabilitative approaches under a physician's supervision, such as physical therapy or chiropractic.

Week 6

Day 36: Under chiropractic care, you should show improvement after three weeks. Whatever your course of treatment, if the lower back pain is worsening, it is probably time to have additional diagnostic testing ordered, such as an MRI or CT scan, to better examine soft tissue and bones.

Week 11

Day 71: With physical therapy, your lower back pain should be resolved after eight weeks. While pain reduction is ideal, the overall goal now is working toward independence. With little to no improvement after 12 weeks, you're looking at seeing a specialist in pain management or surgery. For pain management, your options include chiropractic, acupuncture, massage, yoga, supervised exercise, and cognitive behavior therapy or self-regulatory therapy. A 2007 Annals of Internal Medicine study found that these therapies were equally useful for back pain, and whatever you choose should be based on personal preference, cost, and availability of appropriately trained providers. A clinician may also prescribe low doses of antidepressants, because these have been shown to relieve pain, independent of their effect on depression.

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