Updated on March 12th, 2018
Back pain is considered chronic if it lasts three months or longer. It can come and go, often bringing temporary relief, followed by frustration. Dealing with chronic back pain can be especially trying if you don’t know the cause.
If the source of the pain is not known or can’t be treated, your best option may be to work with your doctor on reducing the flare-ups and making the pain manageable with nonsurgical treatments.
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If you have back pain, you know how it can interfere with the simplest of activities, such as sitting in a comfortable position, tying your shoelaces and even falling asleep at night. You might think that the best thing to do is to rest and avoid putting any pressure on your back, but experts now recommend you try to keep moving as much as possible.
1. Physical Therapy
Exercise is the foundation of chronic back pain treatment. It’s one of the first treatments you should try under the guidance of your physician and spine physical therapist. However, the same set of exercises doesn’t work for everyone, says Kotcharian. The exercises have to be tailored to your specific symptoms and condition. Maintaining the exercise routine at home is also a big part of success.
Physical therapy for chronic back pain may include:
- Retraining your posture
- Testing the limits of pain tolerance
- Stretching and flexibility exercises
- Aerobic exercises
- Core strengthening
Some diets are highly inflammatory, especially those high in trans fats, refined sugars and processed foods. Consult with your doctor to see if your diet could be contributing to your chronic back pain and how you could change it. Maintaining a healthy weight could also help lessen your back pain by reducing the pressure on your spine.
3. Lifestyle Modifications
When you have chronic pain, it’s important to accept your limitations and adapt. “Listen to your body and learn to pace yourself,” suggests Kotcharian. Take a break when mowing the lawn, or make several trips when carrying groceries. Take note of the activities that worsen your pain and avoid them if possible. Not only could this help your back feel better, it could also prevent the underlying condition from advancing.
Another important lifestyle change to try is giving up smoking. Nicotine is scientifically known to accentuate pain and delay healing.
4. Go hot and cold
Break out that bag of frozen peas (or an ice pack, if you want to get fancy) for the first 48 hours after the pain sets in, and put it to use for 20 minutes a session, several sessions per day. After those two days are behind you, switch to 20-minute intervals with a heating pad. Localized cooling shuts down capillaries and reduces blood flow to the area, which helps ease the swelling.
Cold also thwarts your nerves’ ability to conduct pain signals. Heat, on the other hand, loosens tight muscles and increases circulation, bringing extra oxygen to the rescue.
5. Rethink that mattress
A number of studies over the years suggest that people with lower back pain who sleep on medium-firm mattresses do better than those with firm beds. As for replacing yours, “there’s no hard-and-fast rule,” Sean Mackey, chief of the division of pain medicine at Stanford University, says, “but if your mattress is sagging significantly or is more than 6 to 8 years old, I’d think about getting a new one.” Best mattress for back pain
6. Focus on your feet
Some back trouble starts from the ground up. Women whose feet roll inward when they walk (what’s known as pronation) might be particularly susceptible to lower back pain, according to a recent study in the journal Rheumatology. Another study finds that correcting the problem with orthotics may help. Before you shell out for custom-made inserts, try an off-the-rack model, like those made by Powerstep.
7. Get on up
Taking it too easy is the enemy here, ancient advice regarding the benefits of bed rest to the contrary. Gentle stretches, walking, and periodically standing up at your desk can help stabilize your spine and prevent muscle imbalances. And despite how hard it is to imagine doing Downward-Facing Dog with a bad back, yoga can work in your favor, too. A 2013 review of studies found strong evidence it can help beat lower back pain.
8. Get a massage
Massage is a popular therapy that can help relieve muscle tension, spasms, inflammation, aches, stiffness, and pain. It can also help improve circulation, flexibility, and range of motion. Massage can be administered by a professional or you can give yourself a mini-massage using hand-held massagers that can help increase blood flow and relieve pain.
9. Exercise your core
The muscles in your abs and back play a critical role in supporting your lower spine. These muscles don’t get a good workout during the course of a normal day—they need to be specifically targeted through exercise.
10. Stretch your hamstrings twice daily
One often overlooked contributor to lower back pain is tight hamstrings. If your hamstring muscles—located in the back of your thighs—are too tight hamstrings your lower back and sacroiliac joints will be stressed, leading to more pain. Hamstring stretching should be done carefully and at least twice per day.
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