Treatment

Back pain will usually improve within a few weeks or months. There are several things you can try to help reduce your pain in the meantime.

There are also some specialist treatments that may be recommended if it's thought simple measures aren't likely to be effective on their own.

See your GP or a physiotherapist if your pain isn't improving despite trying simple treatments.

The main treatments for back pain include:

Treatments you can try yourself

Stay active

One of the most important things you can do is to keep moving and continue with your normal activities as much as possible.

It used to be thought that bed rest would help you recover from a bad back, but it's now known that people who remain active are likely to recover more quickly.

This may be difficult at first, but don't be discouraged – your pain will start to improve eventually. Consider taking painkillers if the pain is stopping you from carrying on as normal.

There's no need to wait until you're completely pain-free before returning to work. Going back to work will help you return to a normal pattern of activity and may distract you from the pain.

Back exercises and stretches

Simple back exercises and stretches can often help reduce back pain. These can be carried out at home as often as you need to.

For information about the types of exercises and stretches that can help, see:

Your GP may be able to provide information about back exercises if you're unsure what to try, or you may want to consider seeing a physiotherapist for advice. Read about how to find a physiotherapist.

Doing regular exercise alongside these stretches can also help keep your back strong and healthy. Activities such as walking, swimming, yoga and pilates are popular choices.

Painkillers

Non-steroidal anti-inflammatory drug (NSAID) tablets, such as ibuprofen, can help relieve back pain. Many types are available to buy from pharmacies or supermarkets without a prescription.

But NSAIDs aren't suitable for everyone, so check the box or leaflet to see whether you can take the medicine first. Speak to a pharmacist if you're not sure.

If you can't take NSAIDs, alternative medicines such as codeine may help. This is a stronger painkiller that should ideally only be used for a few days, as it can cause addiction if used for longer.

Paracetamol on its own isn't recommended for back pain, but it may be used alongside stronger painkillers such as codeine.

Muscle relaxants may be prescribed by your GP if you have painful muscle spasms in your back.

Hot and cold packs

Some people find that heat – for example, a hot bath or a hot water bottle placed on the affected area – helps ease the pain when back pain first starts.

Cold, such as an ice pack or a bag of frozen vegetables, placed on the painful area can also help in the short-term. However, don't put the ice directly on your skin, as it might cause a cold burn. Wrap an ice pack or bag of frozen vegetables in a cloth first.

Another option is to alternate between hot and cold using ice packs and a hot water bottle. Hot and cold compression packs can be bought at most pharmacies.

Relax and stay positive

Trying to relax is a crucial part of easing the pain as muscle tension caused by worrying about your condition may make things worse.

Read more about:

Although it can be difficult, it helps if you stay optimistic and recognise that your pain should get better, as people who manage to stay positive despite their pain tend to recover quicker.

Specialist treatments

Exercise classes

Your GP may suggest attending an NHS group exercise programme if they think it might help reduce your pain.

These programmes involve classes led by a qualified instructor, where you're taught a mix of exercises to strengthen your muscles and improve your posture, as well as aerobic and stretching exercises.

Manual therapy

Manual therapy is the name for a group of treatments where a therapist uses their hands to move, massage and apply careful force to the muscles, bones and joints in and around your spine.

It's usually carried out by chiropractors, osteopaths or physiotherapists, although chiropractic and osteopathy aren't widely available on the NHS.

Manual therapy can help reduce back pain, but it should only be used alongside other measures such as exercise.

There's also some evidence that a therapy called the Alexander technique may help with long-term back pain, although the National Institute for Health and Care Excellence (NICE) doesn't currently recommend this treatment specifically.

Psychological support

Your GP may suggest psychological therapy, in addition to other treatments such as exercise and manual therapy.

Therapies such as cognitive behavioural therapy (CBT) can help you manage your back pain better by changing how you think about your condition.

While the pain in your back is very real, how you think and feel about your condition can make it worse.

If you've been in pain for a long time, a specialist treatment programme that involves a combination of group therapy, exercises, relaxation, and education about pain and the psychology of pain may be offered.

Surgery and procedures

Surgery for back pain is usually only recommended if there's a specific medical reason for your pain, such as sciatica or a slipped (prolapsed) disc, and other treatments haven't helped.

But a procedure called radiofrequency denervation may sometimes be used if:

  • you've had back pain for a long time
  • your pain is moderate or severe
  • your pain is thought to originate from the joints in your spine

This procedure involves inserting needles into the nerves that supply the affected joints. Radio waves are sent through the needles to heat the nerves, which stops them from sending pain signals.

You're awake while the treatment is carried out and local anaesthetic is used to numb your back. You won't need to stay in hospital overnight.

As with all procedures, radiofrequency denervation carries a risk of complications, including bleeding, bruising, infection and accidental nerve damage. Discuss the risks with your surgeon before agreeing to treatment.

A number of other treatments have sometimes been used for non-specific back pain (back pain with no identified cause), but aren't recommended by the National Institute for Health and Care Excellence (NICE) because of a lack of evidence.

These include:

  • belts, corsets, foot orthotics and shoes with "rocker" soles
  • traction – the use of weights, ropes and pulleys to apply force to tissues around the spine
  • acupuncture – a treatment where fine needles are inserted at different points in the body
  • therapeutic ultrasound – where sound waves are directed at your back to accelerate healing and encourage tissue repair
  • transcutaneous electrical nerve stimulation (TENS) – where a machine is used to deliver small electrical pulses to your back through electrodes (small sticky patches) attached to your skin
  • percutaneous electrical nerve stimulation (PENS) – electrical pulses are passed along needles inserted  near the nerves in the back
  • interferential therapy (IFT) – where a device is used to pass an electrical current through your back to try to accelerate healing
  • painkilling spinal injections (although these can help if you have sciatica)
  • spinal fusion or disc replacement surgery
Media last reviewed: 28/05/2015
Next review due: 28/11/2017

Page last reviewed: 23/01/2017
Next review due: 23/01/2020