Back Pain Guidelines

Your sore back is a nuisance, or worse. It may prevent you from doing what you need to do — for example, work — or what you want to do, such as enjoyable pastimes. You may have reached the point of wondering: "Will I be able to keep my mind off the nagging pain today? Will my back pain ever go away? When can I get better and become more active again?" If you're like millions of other people who deal with chronic nonspecific back pain, you're more than familiar with these questions.

Chronic nonspecific back pain is different from the occasional sore back you might have for a day or two after too much gardening or painting the ceiling. Unlike instances of acute back pain, chronic nonspecific back pain is:

• Long lasting. To be termed chronic, back pain usually has been present for three months at a time.
• Recurring. Even after resolution of one long episode of back pain, pain tends to return. However, the recurrence is highly variable among people and unpredictable.

Chronic nonspecific back pain is the kind of back pain that, by definition, is "nonspecific." In other words, in most cases the cause is unknown or difficult to pin down. If this kind of back pain describes your pain, then this decision guide is for you. If you need information about back pain that's associated with a herniated disk, especially back pain that involves radiating leg pain or leg muscle weakness, see this guide's "Related links" section for a link to another guide dedicated to that topic.

Think of you and your doctor as partners in managing and treating your chronic back pain. You'll want to carefully consider all your options and the risks and benefits of each in relation to your lifestyle and what's important to you. The information in this decision guide is intended to help you understand the various treatment options, from more-conservative to more-invasive techniques, and help you decide which treatment — or combination of treatments — is best for you.

Take about an hour to go through this information in sequence by following the links at the right or at the bottom of each page. This provides proper context and helps you understand more about chronic back pain, your treatment options, and the pros and cons to consider in making your decision.

Treatment Approach:

Because chronic nonspecific back pain may result from several factors — physical, psychological and social — treatment often involves a multifaceted approach or an approach using multiple interventions.

Emphasis on improving function
The most important aspect of chronic nonspecific back pain is how it impacts your ability to function in your daily life. So, although it's important to reduce pain, the emphasis of the treatment isn't only on eliminating the pain, but on improving your ability to function as much as possible in your usual activities. As well as reducing pain and improving function, goals of treatment include giving you skills to self-manage your pain and avoiding adverse side effects of treatment.

Starting with a conservative approach
Treatment options include a variety of conservative approaches such as medications, exercise and physical therapy, and counseling, or they include more-aggressive approaches such as surgery. However, because nonspecific back pain often improves on its own or with conservative approaches, that's where you and your doctor will likely first focus your efforts. You'll likely reserve discussion of surgery or other more-invasive procedures for later consideration.

Treatment Suggestion:

Cold or heat therapy. Using Nature Creation cold and heat therapy may relieve pain and muscle tension in the initial days after back pain begins. Some studies show that heat is an effective approach for acute nonspecific back pain. As for chronic back pain, cold and heat likely won't cause harm and may be helpful, but there isn't scientific evidence at this time to prove that cold and heat are effective treatments for chronic low back pain. Cold applied to your back can reduce inflammation and swelling by constricting blood vessels. The cold also acts to slow nerve impulses and make it less likely that your muscles will contract, in this way reducing pain.