Quick. You just hurt your lower back. What do you do?

If you’re like most back pain sufferers, you’ll reach for a bottle of pain killers and go lie down. But is that really the best way to get back on your feet and keep the pain away?

Use this guide during those important first hours after injury to help your back recover quickly, or even for pain relief from chronic back pain flare ups.

First 15 Minutes: Apply Ice

Apply ice as soon as possible after injuring your back – preferably within five minutes. The sooner you apply the ice the more it will help. This can be a cold pack, ziplock bag of crushed ice, or even a bag of frozen vegetables like peas or corn.

Use a circular massaging motion when applying to prevent the ice from resting in one place too long (a spouse or friend can help ice
massage your lower back), or simply place a thin towel between the compress and your skin to help prevent frostbite. Apply ice up to 20 minutes at a time. This can be repeated over the course of the first few days, or after flare ups.

The cold will cause nearby blood vessels to constrict, helping minimize swelling and painful inflammation which has already started. It numbs painful nerves. And the cold stimulates your body to rush more oxygen-rich blood full of antibodies and vital nutrients to repair the injury and carry away waste products as it attempts to warm the area you are cooling with the ice.

First Hour: Apply Heat

Applying heat after you ice your back may seem odd. But ice
followed by heat is a powerful way to shock your back out of the pain-spasm cycle. Try 20 minutes of ice followed by 20 minutes of heat. Repeat up to three times and you should get at least some relief from even severe lower back pain.

There are numerous ways to apply heat. Two of my favorites are a hot tub (if you have one available) or a far infrared heating pad. Not to be confused with a standard heating pad which will help in a pinch, far infrared heat penetrates up to three inches deep to warm the muscle itself instead of just the skin area. Other great ways to apply heat include ultrasound, pain creams, and even a long hot shower.

As heat is applied, your back muscles relax and circulation increases again as your body sends fresh blood supply to cool the area back to normal. Repeat heat treatments as necessary.

First Day and Beyond: What else you should do

Acute lower back pain typically comes on suddenly and can be painful enough to take your breath away, or even drop you to your knees. While ice
and heat can break the initial pain-spasm cycle, you also need to consider how much you should rest, when you should exercise, and what to do about continuing pain and inflammation. Here’s what I recommend.

Anti-inflammatories and Pain Relief

Inflammation is your body’s natural response to an irritant, such as a sprained back. Inflammation is a normal part of the healing process. The problem is our bodies lose the ability to turn off the inflammatory response as we get older. By our late 20s, chronic systemic inflammation becomes a real health concern.

While non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and naproxen can help with both pain and inflammation during acute lower back pain, they also carry significant cardiac and digestive health risks. A better option for most people are proteolytic enzymes which naturally reduce inflammation and its resulting internal scar tissue.

Rest

Yes, you need to rest your lower back. Certainly, if a certain activity led to a case of acute lower back pain don’t repeat it for at least a week. For example, if your back pain started after lifting something heavy, don’t lift heavy objects for at least a week to give your back time to recover.

But don’t take rest too far. Studies have shown that too much bed rest (more than a couple days) can nearly double how long it can take to recover. In fact, some evidence shows there is little or no benefit to bed rest at all over staying active, but your level of pain will determine that at the outset. Listen to your body.

Exercise

Exercise, including both strengthening and stretching, is important for your long-term recovery. Many cases of lower back pain start with muscle imbalances, where some muscles are overly tight while opposing muscles are too stretched out. You’ll want to be very careful your first couple of days, but some light stretching can often reduce lower back pain by relieving tension.

One easy stretch to try can be done while lying in bed. Gently raise your knees from the bed to your chest, then put a slight pressure on your
knees for a light stretch in your lower back. This stretch can help relieve pain spasms in your back faster than waiting on them to resolve on their own. But again, take it easy and listen to your body – the stretch should not add to your pain.

Going forward

Whether your acute lower back pain goes away quickly or becomes chronic, you want to give your body the best chance at not only overcoming pain,
but preventing it from returning. You will find what has worked for thousands of other lower back pain sufferers in my free book, The 7-Day Back Pain Cure.

Related references

Dahm KT, Brurberg KG, Jamtvedt G, Hagen KB. Advice to rest in bed versus advice to stay active for acute low-back pain and sciatica. Cochrane Database of Systematic Reviews. 2010 Jun 16;6:CD007612.

Deyo RA, Diehl AK, Rosenthal M. How many days of bed rest for acute low back pain? A randomized clinical trial. The New England journal of medicine. 1986 Oct 23;315(17):1064-70.

Waddell G, Feder G, Lewis M. Systematic reviews of bed rest and advice to stay active for acute low back pain. The British Journal of General Practice. 1997 Oct;47(423):647-52.