Back pain is common in Australians, with nearly 85% of the population experiencing a back pain episode at some stage in their life. Unfortunately effective treatment for back pain seems a lot harder to come by. Our natural tendency is to break into the medical cabinet, but are over the counter medications really helpful for managing back pain?

Treatments Shown to be Ineffective

Paracetamol & Anti-Inflammatory medications

Recent studies have shown that paracetamol is ineffective for managing back pain[1], similarly non-steroidal anti-inflammatory medications such as ibruprofen and diclofenac acid (eg Nurofen & Voltaren) have been shown to have minimal clinically important benefits with a high risk of side effects such as gastrointestinal reactions [2]

Opiate Medication

In Australia, approximately 20% of people who present with back pain will be prescribed an opioid painkiller. Opioids have serious side effects including misuse, overdose and dependence. Many people cannot tolerate taking opioid medication and for those who can, only a modest short-term relief of pain was achieved [3].

Bed Rest

While certainly not assisting , bed rest has even been shown to slow recovery. While continuing with heavy work or physical activity is not advised, rest should be relative. Normal activity should resume as soon as you are able. Read more about bed rest and back pain in our previous article.

Imaging

Even when the exact cause of back pain is known or able to be seen on Xray or MRI, it is unlikely to change the plan for management. Imaging is therefore considered an unnecessary cost and risk for back pain sufferers. Check out our video on Do Xrays and Scans Improve Back Pain Treatment?

So… I’ve got back pain, what DO I do?

So if the most commonly prescribed medications don’t work and you have back pain, what do you do?

Luckily it’s not all doom and gloom, we have you covered. Here’s the interventions that have been shown to be of benefit in managing back pain:

Treatments Shown to be Effective

Education and Exercise

Education is one of the most important factors for both prevention and management of back pain. Once you understand what triggers an episode of back pain, it’s far easier to avoid it. Things like manual labour, lifting and moving heavy loads, performing activity in awkward or sustained postures, being poorly trained to perform a work, gym or sporting activity, or being tired or fatigued can all contribute to the onset of back pain and injury.

It’s all well and good to tell me I should have avoided getting back pain in the first place, but now I have it, how can education help?

Once you have back pain, tailored advice and information can help you to manage your injury. In most cases back pain will be episodic, meaning the pain will be temporary for a relatively short duration. Advice from a trained health professional can help to keep you active during your recovery, without risking exacerbation of your condition for example: going for short walks and avoiding long periods of sitting.

Physiotherapy Treatment

Physios can assist you manage your back pain with manual therapy and massage as well as exercise programs such as

and other stretching and strengthening exercises and aerobic exercise. Physio intervention has been found to be an effective way to manage back pain with little to no side-effects [4].

Other Health Interventions

For those with long-term persistent back pain, or those struggling to make the recovery they are after, it is beneficial to look at the “full-picture” and consider what other factors may be impacting on their pain. We call this the bio-psycho-social model which is short for biological (the physical component), psychological (the mental component) and social components of a person’s life. It is important to take into account the stresses, anxieties and demands of your everyday life and consider how this may be impacting on the management of your back pain. Seeing a registered Psychologist may assist you with coping and planning strategies during your recovery [5].

Controlling your body weight, eating healthily, engaging in regular physical activity and lowering stress and anxiety will all assist with managing your back pain, not to mention the overall general health benefits [6].

While we would love to offer the magic cure to take away back pain forever the evidence shows a quick fix with pain killers isn’t the answer for back pain sufferers.