first aid for back pain

[jackflaming]

What is effective first aid for back pain. If I am not able to go to doctor and buy medicines from store, is there any home based treatment for it? Please give your ideas.

[dallas]

From an article on medscape

Physical Therapy

The treatment program for mechanical low back pain (LBP) must have specific functional goals and can be outlined in the following 6 steps:
•
Control of pain and the inflammatory process - Pain treatment should be initiated early and efficiently to gain control. Ice, transcutaneous electrical nerve stimulation (TENS), and relative rest may help with controlling the pain and the inflammatory process. Excessive bedrest, however, may be detrimental by leading to lumbar segment motion, loss of muscle strength, and general deconditioning with blunting of motivation.

•
Restoration of joint ROM and soft tissue extensibility - Extension exercises may reduce neural tension. Flexion exercises reduce articular weight-bearing stress to the facet joints and stretch the dorsolumbar fascia. The use of ultrasound therapy may improve collagen extensibility.

•
Improvement of muscular strength and endurance - Exercise training can begin after the patient has passed successfully through the pain control phase. The key is to attain adequate musculoligamentous control of lumbar spine forces to minimize the risk of repetitive injury to the intervertebral disks, facet joints, and surrounding structures. Start with isometrics, then progress to isotonic exercises with effort directed at concentric strengthening.

•
Coordination retraining - Dynamic exercise in a structured training program maximizes coordinated muscle group activities that lead to postural control and the fusion of muscle control with spine stability.

•
Improvement of general cardiovascular condition - Patients are encouraged to remain active and to initiate brisk walking programs, aquatic activities, or use of stationary bicycles/stair steppers. These activities can increase endorphin levels, promoting a sense of well-being, and allow the patient to perform at a higher level of function before perceiving pain.

•
Maintenance exercise programs - A home program is developed within the tolerance and ability of the patient in order to encourage continued exercise after discharge from physical therapy.


Sertpoyraz et al compared isokinetic and standard exercise programs for chronic low back pain.[13] Pain, mobility, disability, psychological status, and muscle strength were measured. Forty patients were randomly assigned to a program that took place in an outpatient rehabilitation clinic. No statistically significant difference was found between the 2 programs with regard to their effect in the treatment of low back pain.

The main goal of physical therapy in persons with acute back pain is not to increase strength but to achieve adequate pain control. No benefit has been demonstrated for strengthening exercises in persons with acute back pain. Exercise should begin with extension exercises in the prone position after lateral trunk shifts and then progress, as tolerated, to prone lying with support. Flexion exercises can be performed only if the patient has no acute dural tension.[14, 15]

The spine should be stabilized using strengthening of segmental muscles followed by the prime movers of the spine (ie, latissimus dorsi, abdominals, erector spinae). Muscle groups should be strengthened in a neutral position to decrease tension on ligaments and joints; this position allows balanced segmental forces between the disks and the zygapophyseal joints and maximizes functional stability with axial loading.

Physical therapy programs should also include positioning the patient to maximize comfort. Loosening of the hamstrings, glutei, gastrocnemius/soleus group, tensor fascia latae, quadriceps group, and hip flexors also contributes to reduction of LBP and effective conditioning.

In a 2004 multicenter randomized trial, patients who were trained in exercises that matched their directional preference (DP) were more likely to achieve immediate, lasting improvement in pain compared with patients who received nondirectional treatment or opposite directional treatment.[16] Patients using DP exercises were found to have a 3-fold decrease in medication usage. The idea of patient-specific exercises in managing LBP is recognized as controversial by the authors. Using DP to guide patients may improve outcomes in pain, function, and treatment satisfaction.

Jüni et al found that the addition of spinal manipulative therapy to standard care is unlikely to result in relevant early pain reduction in patients with acute LBP.[17] In a randomized trial involving 104 patients with acute LBP, pain reduction during days 1-14 and at 6 months were similar (P = .13) in patients who received spinal manipulative therapy plus standard care—consisting of general advice and acetaminophen, diclofenac, or dihydrocodeine as needed—and those who received only standard care. Small initial differences in analgesic use diminished over time.

Hill et al in a study from 2011 tested stratified primary care with nonstratified current best practice to determine which was clinically more effective and cost-effective for back pain. Patients with back pain (N=851) were placed in the intervention (n=568) and control groups (n=283). The results indicate that after 12 months, the patients who received stratified care showed an overall increase in their health, as well as healthcare cost savings compared with the control group.[18]

Yoga can also be an effective treatment for low back pain, a study by Tilbrook et al has determined. In a randomized, controlled study, 313 patients for a 12-week period either attended yoga classes (n=156) or were given the usual care for chronic low back pain (n=157). After 3, 6, and 12 months, the yoga group demonstrated better back function compared with the usual care group.[19]

A randomized trial of 228 patients compared yoga (n=92), stretching (n=91), and a self-care book (n=45) for alleviation of chronic LBP. The results indicated that stretching classes were the best treatment option in improving function and reducing chronic LBP for at least several months, followed by yoga classes, and then the self-care book. Outcomes were assessed at baseline, 6, 12, and 26 weeks.[20]

Other Treatment


Evidence-based clinical practices on selected rehabilitation interventions for low back pain (LBP) have focused on the timing of interventions.
•
Acute LBP is defined as pain that does not radiate below the knees with current symptoms that have been present 4-6 weeks or less.

•
Subacute LBP is defined as pain that does not radiate below the knees with current symptoms that have been present 4-12 weeks from onset.

•
Chronic LBP is defined as pain that does not radiate below the knees with current symptoms that have been present greater than 12 weeks.

•
The Philadelphia Panel evaluated the literature on the treatment of LBP and assigned Grades of Recommendation based on the clinical importance of the studies, statistical significance of the findings, and the study design.[3] Randomized control trials with statistically significant findings were assigned an A grade. Any study design without clinically significant findings but thought to have been worth performing was assigned a D grade. Grades of Evidence were assigned to the various studies. The highest grades were I for randomized control trials and III for the opinions of respected authorities. ◦For LBP of less than 4 weeks duration, the Philadelphia Panel found poor evidence (grade C) to include or exclude therapeutic exercises, traction, ultrasonography, or TENS. Return to work was strongly encouraged.
◦For LBP of 4-12 weeks duration, the Philadelphia Panel found good evidence for the inclusion of therapeutic exercise and manual traction.
◦For LBP of greater than 12 weeks' duration, the Philadelphia Panel found good evidence for the inclusion of therapeutic exercises, therapeutic ultrasonography, and electromyographic biofeedback. These treatments were positive interventions for achieving adequate pain control, increasing functional activities of daily living, and promoting return to work.

•
Evidence-based clinical practice guidelines from the American Pain Society (APS) for patients with chronic low back pain describe the use of interventional diagnostic tests and therapies, surgeries, and interdisciplinary rehabilitation.[23] ◦Practice guidelines for nonradicular pain ■Interdisciplinary rehabilitation that emphasizes cognitive-behavioral approaches should be considered for patients who fail to respond to usual interventions.
■Provocative diskography (in which material is injected into a disk nucleus to reproduce the patient's typical pain) is not recommended.
■Facet joint corticosteroid injection, prolotherapy (stimulation of an inflammatory response through repeated injections of irritant material), and intradiskal corticosteroid injection are not recommended.
■Degenerative spinal changes and persistent, disabling symptoms should lead to discussion and shared decision-making regarding surgery or interdisciplinary rehabilitation. (The evidence is insufficient to weigh the risks and benefits of vertebral disk replacement in these patients.)

◦Practice guidelines for persistent radiculopathy ■For patients with herniated disks, the use of epidural steroid injection should be discussed.[24]
■For patients with herniated disks and disabling leg pain from spinal stenosis, surgical options should be discussed.
■For patients with persistent pain after surgery, the risks and benefits of spinal cord stimulation should be discussed.


•Exercise was found to be more effective than usual primary care management

[Pieter]

If you're having lower backpain, you're most likely experiencing muscle pain. This is the typical lower backpain that pretty much everybody will experience at some point in their life. Classically people pick something up from the floor misjudging the weight and the muscles in the lower back cramp up.
This kind of backpain normally requires no treatment whatsoever and in The Netherlands the GP will normally not prescribe something or order imaging if the pain is there for under six weeks. He will advise you to keep active (gentle exercising) and avoid being in the same position for longer periods (i.e. don't spend the whole day behind your computer, but walk around a bit every now and then). Other advice might be to keep the muscles warm or take some paracetamol (acetominophen in the U.S.).
You should consult a physician if:
- you experience the first episode when you are under 25 or over 55;
- the pain lasts for more than six weeks;
- the pain is unrelated to movement or is continually there at night;
- you have recently lost significant weight unintentionally or have (had) some form of cancer or
- if you experience radiating pain below the knee, have muscle weakness in the leg (i.e. cannot stand on your toes) or lose control over urine or feces.
I am a physiotherapist and, in my experience, easy cycling is the best treatment for acute low backpain. After the pain is gone (especially if this is not the first episode) it might be wise to get some advice on strengthening your back, proper lifting form and/or posture

[ElevenBravo]

Ill keep it short...



And rest...


Once it gets better start doing some exercises to strength the back and hamstring muscles. Straight leg dead lift, say
start with 20 pounds and work up to 75 pounds (not all in one day, duh). 99% of people have weak backs. Then
there are the ones with a yellow streak down there back but thats a different topic...

Andrew

[kevthemed]

For Muscle strain and tightness. Use Midol. No Midol, then two packets of electrolyte tabs. No electrolyte tabs. Then use straight Magnesium tablets. Mag is a natural muscle relaxant. No Mag. Consume indica hemp.

[Bonecrusher Doc]

Assuming this is garden-variety mechanical back pain and that you have no contraindications such as a pacemaker or decreased skin sensitivity, I personally would us a cold pack/ice, a TENS unit, and specific exercises, perhaps those from Robin McKenzie's book 7 Steps to a Pain-free Life - a hokey-sounding title that combines his previous editions of Treat Your Own Back and Treat Your Own Neck. This advice of course may not apply to your specific situation... for all I know you might have kidney stones or a fracture or cancer or who knows what else.

The nice thing about ice and a TENS unit is that they don't make you drowsy like muscle relaxants often do.
Not sure if they make TENS units that run on AAs; usually they require 9v batteries.

[pascalywood]

For Muscle strain and tightness. Use Midol. No Midol, then two packets of electrolyte tabs. No electrolyte tabs. Then use straight Magnesium tablets. Mag is a natural muscle relaxant. No Mag. Consume indica hemp.

This makes sense. My kung-fu teacher taught me that the content of the nervous liquid that relaxes the muscles is in fact magnesium. The liquid that contracts muscles is mostly made of free calcium and chlorine.

[Dawgboy]

Somebody beat me to Robin Mackenzie...

Ice, then heat. repeat...

[Vicarious_Lee]

Dallas linked the correct stuff.

For now, relative rest is good, and use heat or ice, whichever works better (it's usually heat). Access to a whirlpool tub with jets you can aim at sore muscles is awesome. Ibuprofen is great if your stomach can take it and you aren't allergic.

A prescription muscle relaxer like robaxin is good, mostly at night, and only for a few days after the injury.

Gentle stretching when warmed up.

Then, once you're feeling better, YouTube things like "Lumbar stabilization" for a series of simple exercises that can get your core stronger and less prone to injury.

[SteelWolf]

I just go to the VA, which gives me:



/SERIOUS

Rest, stretching, anti-inflamitory. WHat caused the pain? Did you injure anything?

[BigDaddyTX]

I'm tagging this sort of. I go to PT 2-3x a week for lumbar/thoracic/cervical (yeah.. all of them) spine pain, and I've got printouts of the stretches they have me do, just no scanner at home. I usually get a little better while in PT and if I keep it up it'll help quite a bit eventually. If you just strained it or something, all of this is completely unnecessary though. If it's chronic, get a TENS unit. Those things are amazing for what they are. It can make the difference between sleep and no sleep for me at least.

[TodaysBushcraft]

After 3 back surgeries, I have to say I try my best to stay away from the meds. TENS are great! Good quality ice packs, or the ice/ liquid belts, and I take Valarian root every night to help sleep.
Stretching and strengthening your core are key to a futur without pain. Hope it gets better, best of luck to you.


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