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| Treatment for Chronic Low Back Pain | Chronic low back pain is pain that has lasted longer than 3 months. Since low back pain continues beyond 3 months, it becomes crucially important that you develop skills for managing and coping with chronic pain so you can avoid getting into a cycle of sleeplessness, inactivity, depression, irritability and more pain.
Chronic pain often requires either psychological counseling or medical treatment, for the reason that pain has a wearing effect on both the mind and the body. Look for a cognitive-behavioral therapist who can teach you stress management and pain control skills. Search for a "back school" program and at least one type of health professional who specializes in spinal care. The most successful programs are regularly those that mix exercise, activities to increase your function and techniques to help you manage pain. Depending on your condition, you can start taking charge of pain by continuing with home treatment measures and using one or more of the following treatments:
• Daily exercises to strengthen your trunk and back. Consult a physical therapist for specific exercises.
• Medicine if needed. They are not effective for all people, but medicines that doctors sometimes suggest for low back pain include:
o Acetaminophen to reduce pain and/or medicines that reduce pain, swelling, and irritation, including ibuprofen (such as Advil or Motrin), naproxen (such as Aleve or Naprosyn), and ketoprofen. These medicines usually work best if you take them on a regular schedule instead of waiting until the pain is severe.
o Prescription pain medicine or muscle relaxants for a short time, to help break the pain cycle.
o Tricyclic antidepressants, to treat chronic pain. This type of medication not only treats depression but may have an additional effect on chronic pain.
o Anesthetic or corticosteroid injections, to block pain sensation or reduce inflammation.
• Other therapies that include:
o Ice or heat, depending on which seems to help you more, you may try switching between heat and cold as well.
o Therapeutic massage for easing muscle spasm.
o Spine adjustment, by an osteopath, chiropractor, physiatrist, or a physical therapy spine specialist. Those who benefit from this usually notice improvement after one visit and additional manipulation is not needed.
o Cognitive-behavioral therapy or biofeedback, for controlling pain and pain triggers. Consult with a psychologist, licensed counselor or clinical social worker who specializes in pain management skills.
o Acupuncture.
o Spinal cord stimulation, sometimes used for severe, chronic nerve pain.
Several experimental treatments are controversial and not widely used. These include:
• A traction-like treatment called vertebral axial decompression.
• Percutaneous disc decompression such as intradiscal electrothermic therapy (IDET).
• Radiofrequency ablation.
• Botulinum (Botox) injection.
• Prolotherapy.
Facet joint injections and spinal traction are not considered to be safe and effective treatments for chronic low back pain.
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