How to treat lower and upper back pain – the 14 things to try
NHS explain the best ways to treat back pain
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About a third of Brits complain of back pain, but only 20 percent of these people actually see their GP about the problem. Lower back pain is typically more common than upper back pain, but both are very common in the UK. Express.co.uk chatted to Dr Deborah Lee from Dr Fox Online Pharmacy to find out 14 ways to treat lower and upper back pain.
Suffering from lower or upper back pain? You’re not alone.
Around 2.3 million GP consultations every year are centred around back pain.
It’s important to solve the problem, as back pain has physical, psychological, and social effects.
Dr Lee added: “It disrupts the ability to execute daily tasks, to sleep and exercise, and it results in sadness, anxiety and depression, loss of hope for the future, and causes further health anxiety.
“Back pain also curtails daily life due to the inability to go out, leading to social isolation, and being unable to participate in hobbies and pastimes.”
Not sure where to start? Dr Lee reveals 14 ways to beat back pain.
Stay active
It may seem counterintuitive to move your back when it hurts. However, lying still for hours on end will cause your back to seize up and make the pain worse.
Dr Lee added: “You need to keep active. Walking, swimming, yoga and pilates can help, and you should also try gentle stretching exercises.”
Take non-steroidal anti-inflammatories (NSAIDs)
NSAIDs such as ibuprofen, diclofenac or naproxen will help.
Dr Lee said: “These help reduce inflammation and improve the pain.
“If you get gastric symptoms on NSAIDs you may need additional medication to protect the stomach, so you should discuss this with your doctor.”
Try applying a hot or a cold pad to the affected area
A hot water bottle wrapped in a towel, or a pack of frozen peas, can be helpful, according to Dr Lee.
Topical agents
Capsaicin or lidocaine can be directly applied to the lower back as cream, gels or sprays, and can be effective to reduce pain.
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Other analgesics
Opiate pain killers are sometimes used, but only short term as they can become addictive with unpleasant side effects.
Antidepressants
Low doses of tricyclic antidepressants, or serotonin re-uptake inhibitors (SSTI’s) are often used to treat back pain.
Dr Lee explained: “This is because these antidepressants stimulate the production of neurotransmitters – such as dopamine, serotonin and noradrenaline – and hence modify pain transmission.”
Try to stay positive
Low back pain can be very hard work to cope with, but it usually resolves without any specialist intervention.
Dr Lee suggested: “A positive mental attitude will help you cope better.”
Acupuncture
The technique of acupuncture involves the insertion of very fine needles at certain points on the body which are said to stimulate the production of special energy called ‘Qi’.
Dr Lee said: “Medical studies have confirmed acupuncture can reduce low back pain.
“However, sham acupuncture also has been shown to have similar results.
“Acupuncture remains an option for those whose back pain has not responded to other treatment measures. Always visit a licensed acupuncturist.”
Biofeedback
The biofeedback technique involves measuring the degree of muscle tension using electromyography (EMG), as well as skin temperature, heart rate and breathing rate.
These things correlate with your stress levels and you can be taught how to control these parameters.
Dr Lee said: “Studies of biofeedback have shown it to have a small to medium but significant effect to lower the intensity of back pain.”
Cognitive behavioural therapy (CBT)
CBT is a form of psychological therapy that can help those with chronic pain.
The treatment involves education about the spine and the underlying causes of back pain, Dr Lee said.
She explained: “It aims to challenge the perception of pain, and help develop coping strategies.
“Although medical evidence of the effectiveness of back pain CBT is scarce, what exists seems to show CBT can reduce low back pain and improve depression.”
Transcutaneous nerve stimulation (TENS)
With this technique, two electrodes are placed on the skin over the painful area and a small electric current is passed.
This stimulates the local nerves and causes a tingling sensation.
Dr Lee said: “Frequently, the pain then starts to lessen with this on.
“This may be due to a specific effect on nerve transmission (‘the gate theory’) or perhaps due to an increase in the production of endorphins.”
Physical therapy
Physiotherapists can advise a specific range of exercises to strengthen the back and help improve back pain.
Dr Lee said: “The specific programme will vary depending on the diagnosis, but often involve stretching, dynamic stabilisation and core exercises. Aquatic therapy can be very helpful.”
Spinal manipulation
Spinal manipulation is carried out by chiropractors or osteopaths and involves controlled thrusts into different parts of the spine.
Dr Lee said: “Some studies have shown it can improve low back pain, but the overall quality of medical evidence is low.”
Spinal injections
Epidural injections are often very effective at relieving low back pain, according to Dr Lee.
She explained: “An epidural injection means injecting a local anaesthetic into the epidural space around the spinal cord and nerve roots.
“Research suggests 70 to 90 percent of patients will experience pain relief after an epidural for anything from one week to one year.”
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