Treating Back Pain at Home

Fast Facts:

• Learn to take care of your back if you work remotely at a desk.
• Find out when you should talk to your doctor.
• Explore new treatments available for back pain.

Most people think back pain is caused by lifting heavy objects. While that can be true, the back is often aggravated by sitting at a desk or in a car for long periods. As more people work remotely in front of computers, this is becoming an increasing concern.

Fortunately, there are ways to help prevent or ease back pain at home. Jane Varner, M.D., a Sutter family medicine doctor in Palo Alto, answers questions on tried-and-true methods and common mistakes and advises when it’s time to call your doctor.

Can most back pain be treated at home?

Generally, yes. But it's important to look at all factors before deciding whether you need to see a doctor. Some people have chronic but stable back pain, meaning they occasionally have flare-ups, but they usually know what works for them so they feel comfortable treating the pain at home.

Then you have new-onset back pain that has a clear cause: Maybe you picked up something heavy or tried a new workout the previous day. That kind of pain responds very well to home care.

New-onset back pain without a clear reason offers more cause for concern. Maybe you woke up with it. Or maybe it came on gradually, but you have a medical history that merits more caution. Then it's important to get an evaluation by your doctor, just to rule out anything more serious.

How can I deal with low back pain when I have to be at my desk for hours for my job?

Movement is often the best medicine to help ease low back pain. Take short breaks a couple of times each hour. Stand up, stretch and walk around for five to 10 minutes.

It also helps to set up an ergonomic work area. Consider an adjustable desk so you can stand for brief spells while you work. And invest in an ergonomic chair that provides low back support.

Are there medications that can help me?

Yes. Non-steroidal anti-inflammatory medications (NSAIDs) like ibuprofen (Advil, Motrin) or naproxen sodium (Aleve) may help. That's assuming you don’t take blood thinners or have kidney problems or high blood pressure. People in those categories should always check with their doctor first. NSAIDs are different from straight pain medications, such as aspirin or acetaminophen (Tylenol), because they target inflammation.

If those pain relievers don’t help, talk to your doctor about trying a muscle relaxer. But use them with caution. Muscle relaxers can cause sleepiness or dizziness.

Some antidepressants such as duloxetine and amitriptyline have also been shown to help ease back pain. And narcotics can be effective if used for a very short time. But opioids are highly addictive and should only be used temporarily, with close medical supervision.

How long should I use NSAID medications?

Give it a few days, assuming the medication at the correct dosage is helping. That doesn't mean the pain won’t return as the NSAID wears off, but that the medication helps the pain. If you don’t notice any change after two to three doses over the course of a day, talk to your doctor. You may need another approach.

You should be able to take NSAIDs for up to a week. If you're not getting better by then, contact your doctor.

What's better, ice or heat?

There’s no right answer. Try both and note which is most helpful. Ice helps reduce inflammation and can have a numbing effect. But sometimes putting ice on a muscle strain triggers pain and causes the muscles to tense even more. Heat has more of a relaxing effect in that case.

Should I rest in bed?

Bed rest is OK for a very limited time, no more than a few hours. Too much bed rest actually can make back pain worse. Activity will promote blood circulation that helps the healing process.

If you do lie down, tuck a pillow under your bent knees to take the strain off your lower back. If you prefer to rest on your side, place a pillow between your knees.

Will exercises help?

Yes, but it’s important to do the right type of exercises to prevent injury and strengthen your back. Ask your doctor to refer you to physical therapy. A physical therapist can teach you specific movements to improve your posture and strengthen your back and abdominal muscles.

What common mistakes do people make when self-treating back pain?

Most people have pretty good instincts, but there are a few things that aren’t very effective. For instance, some like to apply ointments that generate a warm sensation. These won't hurt you, but they’re mostly creating a skin sensation that gives the perception of heat, so they're not really helping your back.

Others want to get a massage, which isn't a bad idea. But avoid any deep tissue massage, because if you're having a back spasm and someone works hard on it, the muscle may become more irritated. Light massage is OK, as are gadgets like high-density foam rollers, if done gently. As always, if the pain worsens during massage, stop and wait a few days.

When should I see a doctor for chronic back pain?

If you’re not feeling better after a week or two of home care, or you have accompanying symptoms like fever or numbness or tingling in your legs, visit your doctor first for a thorough evaluation. Your doctor will know your situation and history best and recommend next steps that are right for you.

Your doctor may refer you to a back pain specialist. Together you can consider a number of medical treatments available today, such as:

• Cortisone injections, which can help reduce inflammation around the roots of nerves in your back.
• Implanted nerve stimulators, which send electrical impulses to your nerves to block pain signals.
• Radiofrequency ablation emits radio waves that damage key nerves in your back, blocking the nerves’ ability to send pain signals to your brain.
• Surgery, a last resort, is sometimes helpful if your back pain radiates down a leg or is causing increasing muscle weakness.