The central theses
- A recent study found that treating acute back pain appropriately can help people miss fewer jobs.
- Treating back pain from the start could help prevent or reduce the chance of becoming chronic.
- Taking anti-inflammatory drugs can help people with acute back pain.
Back pain can affect many areas of a person’s life, including their ability to get the job done. In fact, new research has found that people who don’t get the right treatment miss more work days than those who do.
Scientists at the University of Utah Health and MDGuidelines found that people with a low back pain injury missed 11 more work days in a year if they only received treatments that weren’t recommended by medical guidelines, compared to those who did.
The researchers used a cohort of nearly 60,000 people whose data came from California’s employee compensation claims reported to the Department of Labor Relations ‘Workers’ Compensation Information System from May 2009 to 2018.
To assess whether someone was receiving the recommended treatment, researchers used the American College of Occupational and Environmental Medicine (ACOEM) guidelines for back pain practice.
Some of these recommended treatments included:
- Ketorolac injections
- Acetaminophen (Tylenol)
- Physiotherapy or occupational therapy
The study was published in the journal PLOS ONE in mid-June.
Recommended treatments made a difference
The majority of those included in the study received at least some non-recommended treatments for lower back pain. Researchers found that:
- 14% only received non-recommended treatments
- 51% received a mix of non-recommended and recommended treatments
- 14% received only recommended treatments
The guidelines recommend doctors avoid treatment with electrical stimulation and opioids. One bright spot in these results points to a dramatic 86% decline in opioid prescriptions from 2009 to 2018.
Overall, the researchers found that “workers who received only recommended interventions had 11.5 fewer lost days, a reduction of 29.3% compared to those who received only non-recommended interventions.”
“I’m not at all surprised that people will be much more productive when properly treated,” Neel Anand, MD, professor of orthopedic surgery and director of spinal trauma at Cedars-Sinai Spine Center, told Verywell. “The problem is immensely ignored. ”
What to do after acute lower back pain
For people with acute low back pain, it can be easy to dismiss it as not a problem. Lower back pain doesn’t always require medical attention, but there are steps people can take to manage their back pain as it interferes with their daily lives.
Acute back pain that lasts less than four weeks according to the Centers for Disease Control and Prevention becomes chronic if it lasts more than 12 weeks.
Anti-inflammatory drugs can also help with lower back pain.
“The best way to do this is to use a brief anti-inflammatory treatment because the muscles, ligaments, and tendons are all inflamed,” Medhat Mikhael, MD, pain management specialist and medical director of the non-surgical program at that Spine Health Center at MemorialCare Orange Coast Medical Center, says Verywell.
People can take this anti-inflammatory drug even at the onset of pain by buying over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen sodium.
Some alternatives may include muscle relaxants, which are moderately recommended in the ACOEM back pain practice guideline.
When the pain is acute, many people can be tempted to lie in bed. Mikhael and Anand both advise against it.
While some rest is fine, it’s important that people keep using their back muscles. People may also want to consider sitting in a firmer chair, although it may be a little uncomfortable.
“You don’t want to sit on a soft sofa seat,” says Anand. “Sitting usually causes more pain than standing, so if you are in the acute painful phase, you may want to stand.”
While exercise is important, Anand recommends “staying away from certain activities that are causing the pain”.
Avoid going to the chiropractor right away
Massage can be helpful in treating different types of pain, but people should be careful when going to a chiropractor.
“Sometimes chiropractors can get very aggressive and try to manipulate a lot, adjustments that sometimes flare up symptoms even further and delay the healing process,” says Mikhael.
Instead, Mikhael recommends people take a few physical therapy sessions to see if this improves their pain.
What that means for you
Lower back pain can disrupt a person’s life. If it is affecting your pain, you can speak to a doctor about what you can do to better manage your pain. You can ask them if they follow certain guidelines when prescribing treatment.
Good Labor Practices to Keep in Mind
For people who have a job that involves sitting in front of a computer for most of the day, there are still steps they can take to prevent or limit the development of back pain.
“My number one recommendation is appropriate ergonomics for the desk job,” says Mikhael. “People sit on theirs [spinal] Discs and the computer is much higher than your head. Your chairs are awful and they don’t have good back support. ”
He suggests investing in a better chair and, if possible, also paying attention to the positioning of the computer.
A study published in the journal Applied Ergonomics in November 2019 linked back pain in people who have desk jobs to their habit of staying still for most of the day. “People with chronic LBP showed a possible trend … towards more static sitting behavior compared to their pain-free counterparts,” the researchers write.
Because of this, Mikhael encourages people to take advantage of the times when they can move. “Always take your 10-minute breaks and use them to your advantage,” he says. “Get up and walk around to relieve the pressure on your intervertebral discs, nerves, and ligaments.”