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| Medical Treatment | Primary treatment of low back pain is based on the assumption that the pain in about 90% of people will go away on its own in about a month. A lot of different treatment options are available. Some of them have been proven to work, while the others are of more questionable use.
 For the initial treatment of low back pain is suggested home care. Insufficient rest still remains of untested value and most experts advise no more than 2 days of bed rest or decreased activity. On the other hand some people with sciatica may get benefit from 2-4 days of rest. Application of local ice and heat provide relief for some people and should be tried. For pain control are most useful acetaminophen and ibuprofen.
Lots of studies have called into question the helpfulness of the current treatment of back pain. For any given person, it is not known if a particular therapy will provide benefit until it is tried. Your doctor may seek treatments known to be useful in the past.
Medications
Your doctor will decide which medication, if any, is best for you based on your medical history, allergies, and other medications you may be taking.
• Non-steroidal anti-inflammatory medications are the core of medical treatment for the relief of back pain, where such preparations as ibuprofen, ketoprofen naproxen and many others are to be had. No particular NSAID has been shown to be more efficient for the control of pain than another. Nevertheless, your doctor may change you from one NSAID to another to discover one that works best for you.
• COX-2 inhibitors, such as celecoxib (Celebrex), are more selective members of NSAIDs. Though increased cost can be a negative factor, the incidence of costly and potentially fatal bleeding in the gastrointestinal tract is clearly less with COX-2 inhibitors than with traditional NSAIDs. Long-term safety - possible increased risk for heart attack or stroke - is currently being evaluated for COX-2 inhibitors and NSAIDs.
• Acetaminophen is also measured helpful for treating acute pain. NSAIDs do have a number of potential side effects, counting gastric irritation and kidney damage, by means of long-standing use.
• Muscle spasm is not commonly accepted as a source of back pain and most relaxants have no effect on it. Muscle relaxants may be more helpful than a sugar pill in treating back pain, but none has been revealed to be better than NSAIDs. No extra benefit is achieved by using muscle relaxants in conjunction with NSAIDs than using NSAIDs alone. Muscle relaxants cause sleepiness in up to 30% of people taking them, so their use is not consistently recommended.
• Opioid analgesics are considered as an alternative for pain control in case of acute back pain. The use of these medications is connected with serious side effects including dependence, sedation, decreased reaction time, nausea and clouded judgment. One of the most bothersome side effects is constipation, which occurs in a huge portion of people taking this type of medication for more than a few days. Some studies support their quick-fix use for temporary pain relief that, however, does not speed up recovery.
• Oral steroids are of no benefit and are not recommended. Steroid injections into the epidural space have not been found to reduce duration of symptoms or advance function and are not presently recommended for the treatment of acute back pain without sciatica. Advantages of healing chronic pain with sciatica stay controversial. Injections into the posterior joint spaces, the facets, may be useful for people with pain related to sciatica. Trigger point injections have not been proven helpful in acute back pain, at the same time trigger point injections with a steroid and a local anesthetic may be helpful in chronic back pain. Still their use remains controversial.
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