Treatment & warning signs

How is back pain treated?

Treatment for back pain generally depends on how long your pain lasts.

Acute (short-term) back pain usually gets better on its own.

Here are some things you can try while you wait for the pain to improve:

Painkillers such as aspirin or ibuprofen will help ease the pain.
Keep as active as possible. As much standing, walking and working as can be tolerated will help.
Alternating hot and cold compression packs to reduce swelling and manage the discomfort.

Usually, the pain will subside within 4 to 7 days.

If there is no improvement after 4 to 7 days, contact your doctor.

Chronic (long-term) back pain is typically treated with non-surgical options before surgery is recommended.

Non-surgical treatments:

Hot and cold packs can help soothe constantly sore, stiff backs.

Exercise can help ease chronic pain and may reduce the risk of it returning. Check with your doctor before starting a new exercise routine.

Traction involves using pulleys and weights to stretch the back, which may allow a bulging disc to slip back into place. Your pain may be relieved during the procedure, although could return once completed.

Behavioral modification teaches you to:

Move your body properly while you do daily activities,especially those involving heavy lifting, pushing, or pulling.
Practice healthy habits, such as exercise, relaxation, regular sleep, proper diet and quitting smoking.

Complementary and alternative treatments are an option when medications and other therapies do not relieve pain.

Examples include:

Manipulation. Professionals use their hands to adjust or massage the spine and nearby tissues.

Transcutaneous electrical nerve stimulation (TENS). Electrodes placed on the skin over the painful area sends mild electrical pulses to nerves. TENS treatments are not always effective for reducing pain.

Acupuncture. This Chinese practice uses thin needles to relieve pain and restore health. Acupuncture may be effective when used as a part of a comprehensive treatment plan for lower back pain.

Acupressure. A therapist applies pressure to certain places in the body to relieve pain. Acupressure has not been well studied for the relief of back pain.

Medications to treat chronic back pain are available over the counter or by prescription:

Pain relievers that are taken by mouth or applied to the skin. Examples include acetaminophen and aspirin.
Nonsteroidal anti-inflammatory drugs (NSAIDs) relieve pain and inflammation. Examples include ibuprofen, ketoprofen, and naproxen sodium.
Muscle relaxants and some antidepressants may be prescribed for some types of chronic back pain.
Your doctor may suggest steroid or numbing shots to lessen your discomfort.

Surgical treatments may be necessary in some cases, including:

Herniated (ruptured) discs, where one or more of the discs that cushion the bones of the spine are damaged. The jelly-like center of the disc leaks, causing pain.

Spinal stenosis, a narrowing of the spinal column that puts pressure on the spinal cord and nerves.

Spondylolisthesis, where one or more bones in the spine slip out of place.

Vertebral fractures caused by injury to the bones in the spine or by osteoporosis.

Degenerative disc disease, or damage to the spine’s discs as a person gets older. In rare cases, back pain is caused by a tumor, an infection, or a nerve root problem called cauda equina syndrome.

In rare cases, back pain is caused by a tumor, an infection, or a nerve root problem called cauda equina syndrome. In these cases, immediate surgery is needed to ease the pain and prevent more problems.

Warning signs

See your healthcare provider right away if:

You have a fever.
The pain worsens.
The pain progressively moves from your back into your leg(s).
There is no pain relief when at rest or it disturbs sleep.

These are warning signs or "red flags" that require prompt medical attention.