Treatment:

  1. Education: Recommend staying active but avoidance of heavy lifting, bending, twisting, and prolonged sitting.
  2. Medications:
    1. Consider simple analgesics for symptomatic treatment (ex. Ibuprofen 400-800 mg po q 6-8 hrs) 3
    2. Consider opioids as a 2nd or 3rd line treatment ( oxycodone 5-10 mg po q 4 hrs) 3
    3. Muscle relaxants helpful in the first 1-2 weeks of acute back pain ( cyclobenzaprine 10 mg po tid) 4
    4. Corticosteroids not recommended in treatment of actue back pain
  3. Epidural steroid injection helpful in pts. with radicular symptoms not responding to 2-4 wks. Of conservative therapy 1
  4. Massage considered safe but not effective 1
  5. Acupuncture: Limited evidence about the use of acupuncture in the treatment of low back pain. 1
  6. Heat/Ice: Insufficient evidence to recommend application of temperature modalities 1
  7. Manipulation: Short term results favor some improvement in pain but no long term benefits demonstrated 1
  8. Exercise: Insufficient evidence to recommend for or against use of exercise. 1
  9. Physical Therapy: (McKenzie method1) to help short term pain relief and disability.