Over 80% of all Americans will suffer acute back pain in their lifetime, and most of these people will have recurrent ‘flare-ups' of their pain (15-20% reporting back pain each year.) These are sometimes brought on by a specific incident where you are performing an unaccustomed or heavy activity. However many times painful spasms will result after minor activities, like reaching for an object or even without a specific known cause.

In 60% of the patients, this pain will disappear within two weeks even without treatment/medication. However, those first two weeks can be quite uncomfortable, and can be eased with self-treatment designed to avoid additionally irritating the back, and to decrease pain. Below is a list of various things you can do to help decrease your symptoms, whether they are mild or severe.

When you have an acute flare up of back pain, you need to:

Use Proper Positioning When Resting
Although sitting may seem like resting to you, your back doesn't think so. If you are sitting slouched, forward flexing puts extra pressure on the spinal muscles and the discs (up to 50% increase in pressure). Sitting with a small folded towel to support the normal curve (lordosis) of the low back (behind your waist) helps you avoid slouching while sitting relaxed. Sitting in a firm chair and avoiding the soft sofa, which makes you slouch, will also help. If your back is very irritated, limiting sitting by staying seated only for short periods of time, and standing up and stretching frequently is usually a much better option. When lying down, a good firm support (but not rock hard) is usually desirable. If your bed is sagging, a piece of plywood under the mattress can improve support. You may be more comfortable at night when you use a small rolled towel under the waist to support the normal curve of the spine instead of sagging when you lie on your side or back.

Ice or Heat
In an acute (recent) injury, ice can be the most effective treatment to reduce pain and spasm. A bag of frozen peas or corn cushioned by a thin dishtowel for 10-15 minutes will temporarily numb the area, and reduce muscle spasm (lie under a blanket if the rest of you is cold). This can be repeated every hour or two. If you have had better relief in the past from heat instead of ice, make sure you limit the time spent on a heating pad to about 20 minutes per hour to avoid overheating the area and increasing the irritation.

Over The Counter Medications
In general, almost all over the counter medications Tylenol, Motrin/Advil or Aleve will decrease symptoms of low back pain, but some patients find one works more effectively than another. It is important to follow carefully the instructions on the label, and check with your physician or pharmacist if you have any questions or are taking other prescription medications. Especially if you are already taking another anti-inflammatory medication from your physician, Motrin/Advil (ibuprofen) and Aleve (naproxen sodium) are very similar (or even the same medication) as prescription anti-inflammatories, and can cause problems if taken together (Tylenol not included in this type).

Watch Posture and Body Mechanics
Although stationary posture was discussed earlier, watching your posture as you move (called body mechanics) doing daily activities will also make a critical difference in how quickly your pain goes away. If your back pain increases with twisting, avoiding twisting when rolling over in bed and making sure you keep your back straight can help reduce your pain even if you are ‘resting in bed'. When getting up from lying down; keep your back straight; turn without twisting onto one side, bend both knees, and lower your feet over the edge of the bed as you use your hands and elbows to push yourself up. When getting up out of a chair, scoot to the edge, and keeping the back straight, use your legs to push up (make sure they are underneath you and not in front of you). Don't lean forward and push up with your arms- bending forward to use your arms may be more uncomfortable.

Movement- Stay Within Pain-free Range, but Keep Moving.
Rest is important, but studies have shown that resting in bed for more than 3 days, actually tends to increase symptoms in the long run, and will make your muscles weaker when you get out of bed. Lying down to take brief breaks is important if your pain is severe, but making sure you move (and move correctly) is also important. Avoid activities that require repeated or prolonged bending or twisting, and avoid lifting altogether for a few days. If you are able to walk comfortably for only 10 minutes, make sure that when you go for a walk that you stay close enough to home to respect your body's demand for limited activity, and don't try to force a 20 minute walk if that increases your pain a lot. Increase your activity gradually, but do walk that pain-free amount twice a day! Remember, at all times you need to keep the normal curve in the back (avoid flexing and twisting) to keep your back from complaining.