Back pain: Management
Managing back pain
Back pain frequently resolves within a few weeks or months.1,2
However, sometimes the pain can persist over the long term, or keep recurring.1
Here we review physiotherapeutic and pharmacological treatment options to help your patients manage their back pain.2–4
Guideline recommendations for treating back pain
Guidance on managing back pain recommends multimodal intervention
Recommendations from the National Institute for Health and Care Excellence and the American College of Physicians are available guiding the pharmacological and non-pharmacological management of lower back pain.2–4
This advice covers several modes of intervention:
- Pharmacological treatments
- Manual therapy
- Physical and/or psychological therapy
Resting for long periods can make back pain worse.1
Certain forms of exercise can relieve pain and improve function as part of a multidisciplinary rehabilitation approach.3
Walking, swimming, yoga and pilates are activities that may be particularly helpful for back pain.1
Specific exercises and stretches are also available for relieving back pain.1
Guidelines recommend that oral non-steroidal anti-inflammatory drugs (NSAIDs) are considered for managing lower back pain.4
Weak opioids with or without paracetamol may be considered for acute lower back pain but only if NSAIDs are contraindicated, not tolerated or ineffective.4
Manual therapies, which involve massage and manipulating the spine, can be considered as part of a treatment package that also includes exercise.1,2,4
Manual therapy can be provided by physiotherapists, chiropractors or osteopaths.
Several guideline bodies recommend application of low-level superficial heat for back pain relief.1,3,5,6
Indeed, superficial heat is the only non-pharmacological treatment for lower back pain that is rated as having a good evidence of efficacy.5,6
Psychological interventions such as cognitive behavioural therapy can be helpful for coping with the pain, as part of a treatment approach that also includes manual therapy and exercise.1,4
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Understanding back pain
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