Treatment:
Education: Recommend staying active but avoidance of heavy lifting, bending, twisting, and prolonged sitting.
Medications:
Consider simple analgesics for symptomatic treatment (ex. Ibuprofen 400-800 mg po q 6-8 hrs)
3
Consider opioids as a 2nd or 3rd line treatment ( oxycodone 5-10 mg po q 4 hrs)
3
Muscle relaxants helpful in the first 1-2 weeks of acute back pain ( cyclobenzaprine 10 mg po tid)
4
Corticosteroids not recommended in treatment of actue back pain
Epidural steroid injection helpful in pts. with radicular symptoms not responding to 2-4 wks. Of conservative therapy
1
Massage considered safe but not effective
1
Acupuncture: Limited evidence about the use of acupuncture in the treatment of low back pain.
1
Heat/Ice: Insufficient evidence to recommend application of temperature modalities
1
Manipulation: Short term results favor some improvement in pain but no long term benefits demonstrated
1
Exercise: Insufficient evidence to recommend for or against use of exercise.
1
Physical Therapy: (
McKenzie method
1
) to help short term pain relief and disability.