The best things to do for a bad back pain episode has challenged people and medical doctors for generations. In the 1980’s bed rest and even a hospital stay was the best option in the USA. In England traction was thought to be the answer to a tight contracted back, that was to gradually stretch it out. Some people had two weeks of traction as the best medical care. Today in England the main medical approach is to provide anti inflammatories and mild over the counter pain killers, with a physiotherapy referral (within a few months). The physiotherapy approach to back pain is to provide reassurance at first. Typically an episode is bad for 3-5 days and can be felt to some degree for 4-6 weeks. People’s episodes are normally over by the time a hands on approach from the NHS is provided. The way the first back pain episode is cared for can have a knock on effect to future pain episodes. If you don’t get fixed at first it just keeps on coming back until you either get fixed or get used to having back pain episodes. 1-3% of back pains will have a sinister aspect eg a red flag such as a collapse fracture
It has been known for 15 years that anti inflammatories are enzyme inhibitors that alter the natural balance between cyclooxygenase (COX) and lipooxygenase (LOX) enzymes. Altering any natural balance creates a drive to re-balance leading to more COX enzyme increasing inflammation after 2 hours. Yes there is a decrease in inflammation in the first 30-60 minutes, then a rebound increase in inflammation begins to develop surpassing previous inflammation levels at about 2 hours after taking the NSAID (Ibuprofen). The marketing of anti inflammatories is highly suggestive having a strong impact on a lot of people.
Recommendations are now recognising that for acute low back pain the best approach is to rest for the first day, then allow yourself to move around as normally as possible, light duties and slow. Consider Chiropractic Care to help (not only this episode but also future episodes – having chiropractic care for your first episode can actually prevent the next episode form occurring).
According to advise from Harvard University medical Doctors, Chiropractic Care is a very good idea. See for yourself at www.health.harvard.edu/blog/heres-something-completely-different-for-low-back-pain-2017070611962