Back Pain

Back pain is the most common problem people see a doctor for, and runs to about $6,000 per person per year in terms of U.S. medical care expenses. So, it's not just you...

Sudden back pain certainly gets your attention, and should also raise some concern especially if a cause is not evident.

Alarm bells should go off if back pain comes with fever, chest pain, shortness of breath, vomiting, loss of normal bowel or bladder function or tingling or weakness in your legs. These may be signs of infection, heart attack, aneurysm rupture, or spinal cord injury and should prompt urgent medical care.

However, most back pain that comes on for no memorable reason or after a hard day brush clearing or gardening is the result of muscle strain.

When this happens, muscle and other connective tissues are torn and your body responds through inflammation which tries to limit the damage by causing swelling and pain. This limits further use of the inflamed strained muscle until it can heal.

Unfortunately, this inflammatory response can be counter-productive as anyone who has "pulled a back muscle" can agree!

So, best treatment at the outset is a cold pack for 15-20 minutes 3-4 times a day for the first day or two to decrease inflammation to the area. Do not put ice right to the skin as this can cause frostbite injury. Use a chilled rice bag or other cold pack.

After the first day or two, use warm packs if this feels better. Do not overuse heat as this can cause burns or worsened muscle spasm.

Anti-inflammatory pain relievers are helpful for both relieving pain and also reducing the inflammatory response. Examples include aspirin, ibuprofen (Motrin, Advil) and naproxen (Aleve). These should be safe to use for brief periods of time assuming that you do not have any pre-existing stomach, liver or kidney problems.

If you smoke or drink or have ever had an ulcer (or if you are simply interested in keeping these medicines from being able to cause an ulcer while you take them), take one 20-mg Prilosec/OTC a day while you are using these medications. This medication is not dangerous to take for over 14 days. The warning on the box is to prevent people who take it and overlook dangerous symptoms from suing the manufacturer.

Please note that normal adult prescription level doses of Aleve would equal two pills twice a day, and Motrin at four pills three times a day.

Normal daily activities can be continued. Just pay attention to your body, and avoid activity that starts to worsen pain.

Back pain can actually take a surprisingly long time to go away. Half of people with simple back muscle strain have pain that lasts over one month; one quarter for over three months and ten percent of folks take over six months to heal up!

If your back is taking longer than seems right, physical therapy can be very helpful in alleviating some of the pain and in strengthening underused muscles that can add support to your back and help you heal more quickly and also prevent re-injury.