Acute back and neck pain: management

Managing acute back and neck pain

Most acute back or neck pains will get better without intervention or respond well to self-care within a few weeks.^1,2 However, physiotherapeutic and pharmacological treatment options can help your patients manage their acute neck or back pain.^3-6

Guideline recommendations for treating acute back and neck pain due to sprains/strains

Graphic summarizing treatment pathway for acute back and neck pain

Guidance on managing acute back and neck pain due to sprains/strains recommends multimodal intervention

Recommendations from the National Institute for Health and Care Excellence and the American College of Physicians are available to guide the pharmacological and non-pharmacological management of acute back or neck pain.^7-9

This advice covers several modes of intervention:

Exercise
Pharmacological treatments
Manual/Physical therapy

Exercise

Certain forms of exercise can relieve acute pain and improve function as part of a multidisciplinary rehabilitation approach.^8,9 This should be assessed on a case-by-case basis.

Based on your clinical judgment, you may recommend mild exercise such as walking, swimming, yoga, and Pilates as physical activities that may be particularly helpful for acute back pain.¹

Specific exercises and stretches are also available for relieving acute back or neck pain.^1,6

Resting for long periods can make acute back pain worse.¹
Pharmacological treatments

The clinical guideline from the American College of Physicians recommends treating acute low back pain with NSAIDs or skeletal muscle relaxants as first line⁹.

Recommendations for treating acute non-low back pain include topical NSAIDs as first line and oral NSAIDs or acetaminophen as second line¹⁰

OTC self-care treatments that the Mayo Clinic recommends for acute neck pain include ibuprofen, naproxen sodium or acetaminophen⁷.
Manual/physical therapy

Manual therapies, which involve massage, can be considered as part of a treatment package that also includes exercise.^1,7,9

Patients that suffer from non–lower back, musculoskeletal injuries can be treated with specific acupressure to reduce pain and improve physical function.⁹
Heat

Several guidelines recommend application of low-level superficial heat for acute back pain relief.^1,8,10

Superficial heat is the only non-pharmacological treatment for acute lower back pain that is rated as having good evidence of efficacy.⁸

How can Aisha & Ben be helped?

Aisha

Aisha* has recently experienced back pain and cannot do as much activity as she used to. She describes back pain, which she developed while hiking and rock climbing.

Aisha needs a solution that will offer her effective relief.

Voltaren is applied to the skin where its anti-inflammatory ingredient, diclofenac, is absorbed through the skin to provide clinically proven pain relief, so Aisha can get back to doing the things she enjoys!^11,12

* Fictional case study.

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Ben

Ben* experienced neck pain after spending long hours working at his computer last week. Deadlines are fast approaching, and Ben can’t concentrate on his work.

Ben needs effective pain relief.

Advil Muscle and Joint acts fast to relieve muscle and joint pain, so that Ben can focus on his work, not his pain.¹³

* Fictional case study.

Find out more

Understanding acute back and neck pain

Causes

Find out about the causes of acute back and neck pain.

Find out more

Signs and symptoms

Explore how to recognize acute back and neck pain and learn when a referral to a doctor is necessary.

Find out more

Overview of headaches and migraines

Find out more about how headaches and migraines impact patients’ lives.

Find out more

Learn more

Advil — for all your patients’ acute pain relief needs

With proven efficacy in acute pain and a well-established safety profile — you can trust the pain relief of ibuprofen in Advil.¹³

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Voltaren products

Help your patients manage their acute, localized muscle, joint and back pain with our pain-relieving topical products.^11,12

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Headaches and migraines

Learn more about headaches and migraines and how they can be relieved.

Learn more

References

National Health Service. Overview: Back Pain. January 2020. Retrieved January 27, 2021. Available at: https://www.nhs.uk/conditions/back-pain/.
Mayo Clinic. Neck Pain: Symptoms & Causes. Retrieved January 29, 2021. Available at: https://www.mayoclinic.org/diseases-conditions/neck-pain/symptoms-causes/syc-20375581
National Institute for Health and Care Excellence. Clinical Knowledge Summaries: Sprains and strains. April 2020. Retrieved January 27, 2021.
Youssef S. Clinical guidelines and evidence base for acute pain management. The Pharmaceutical Journal 2019:1-13.
Predel HG, Hamelsky S, Gold M, Giannetti B et al. Efficacy and safety of diclofenac diethylamine 2.32% gel in acute ankle sprain. Med Sci Sports Exerc. 2012;44(9):1629-1636.
Mayo Clinic. Neck Pain: Diagnosis & Treatment. Retrieved January 29, 2021. Available at: https://www.mayoclinic.org/diseases-conditions/neck-pain/diagnosis-treatment/drc-20375587.
National Institute for Health and Care Excellence. Low back pain and sciatica in over 16s: assessment and management. November 30, 2016. Retrieved January 27, 2021. Available at: https://www.nice.org.uk/guidance/ng59/resources/low-back-pain-and-sciatica-in-over-16s-assessment-and-management-pdf-1837521693637.
Qaseem A, Wilt TJ, McLean RM, et al. Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline From the American College of Physicians. Ann Intern Med. 2017;166(7):514-530.
Qaseem A, Wilt TJ, McLean RM, et al. Nonpharmacologic and Pharmacologic Management of Acute Pain From Non–Low Back, Musculoskeletal Injuries in Adults: A Clinical Guideline From the American College of Physicians and American Academy of Family Physicians Ann Intern Med. 2020;173(9):739-748.
Chou R, Huffman LH. Nonpharmacologic therapies for acute and chronic low back pain: a review of the evidence for an American Pain Society/American College of Physicians clinical practice guideline. Ann Intern Med. 2007;147(7):492-504.
Voltaren Emulgel Back and Muscle Pain Product Monograph. Available here.
Voltaren Emulgel Extra Strength Product Monograph. Available here.
Advil Tablets, Caplets, Gel Caplets, Extra Strength Caplets, Muscle and Joint and 12 Hour Product Monograph. Available here.

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