Spinal manipulation is a therapy offered by the following licensed professional practitioners: chiropractors, osteopaths, and physical therapists. Physical leverage is combined with a series of exercises to adjust the spine and restore back mobility, while easing pain. Ultrasound and traditional massage are often used alongside spinal manipulation.
Acupuncture , which involves the placement of thin needles in the skin for relief of pain, has been found in several studies to be effective in managing both acute and chronic low back pain.
Physical therapy includes exercises, teaching back care principles, and using heat, ice, and other methods to relieve pain.
The purpose of physical therapy is to reduce the pain, strengthen the muscles, increase motion and function, and prevent future injury. Physical therapy should include development of a home exercise program. Treatments may include:
- Cold packs, which are usually used in the beginning to help reduce pain and muscle spasms
- Heat, which is used to relieve pain and muscle stiffness
- Aerobic exercises, such as walking or swimming
- Stretching exercises
Biofeedback teaches people how to control body functions they normally do not think about. It may help you reduce the severity of the pain. A biofeedback therapist will guide you to relax certain muscles or control breathing. A device shows your body’s response.
Relaxing the muscles can help prevent and reduce the severity of muscle tension and back pain. Relaxation techniques may include conscious breathing, visualizing being in a different place, or clearing the mind of any thoughts. A mental health professional can teach you how to perform different relaxation techniques.
Cognitive Behavioral Therapy
Cognitive behavioral therapy is often used to help manage chronic pain and stress. It is a form of talk therapy that may be done as individuals or in a group. A therapist will help you identify negative thoughts and teach you to unlearn these thought patterns. You will also learn new helpful habits that will help you manage your pain with minimal disruption to your life.
Epidural Injections and Joint or Soft Tissue Injections
A steroid medication is injected into the epidural space in the spinal canal to decrease inflammation. These can be repeated if necessary. Other targets for injection include the facet and sacroiliac joints, as well as muscles and other soft tissues.
TENS (Transcutaneous Electrical Neural Stimulation) is a pocket-sized, portable, drug-free alternative to manage chronic pain, including back pain. The unit dispenses a low-volt electrical current through electrodes placed on the skin, which interferes with pain signals to the brain. This FDA-approved device is generally safe, but the following patients are urged to have a discussion first with their physician: pregnant women and those with cardiac conditions and/or pacemakers. Also, you want to avoid leaving it on areas that have decreased sensation, as you could get a burn.
Consult your physician about what exercises may be helpful for lower back pain. While there is mixed medical evidence about just which exercises will strengthen the back, specialists agree that it's important to keep moving. Low-impact activities like swimming, bicycling, and walking are especially recommended. Properly performed abdominal crunches and flexibility exercises are also important for strengthening the stomach muscles and relieving tight back muscles.
When to Contact Your Doctor
More serious symptoms associated with back pain that may require immediate medical attention include:
- Pain that doesn't subside or worsens with rest
- Pain that is worse when you are reclined
- Pain that is severe or that has gotten dramatically worse
- Progressive weakness or numbness in a leg or foot
- Difficulty walking, standing, or moving
- Numbness in the genital or rectal area
- Loss of bowel or bladder control
- Burning or difficulty with urination
- Fever, unexplained weight loss, or other signs of illness
- If there has been any trauma, fall or impact
- If you have a history of cancer, back pain should be evaluated
- Reviewer: Rimas Lukas, MD
- Review Date: 09/2012 -
- Update Date: 00/92/2012 -