General Guidelines for Acute Lower Back Pain Management

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By Dr. Kevin Bloom
Published on January 27, 2013
General guidelines for Acute Lower Back Pain

A few guidelines can help minimize back pain.


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  • For extremely acute lower back pain, apply ice over the lower back region for 10 minutes 3-4 times per day.  If the ice pack is too cold, wrap it in a paper towel or a t-shirt.  If symptoms increase, discontinue use.  Heat is not recommended for extremely acute cases.
  • For lower back pain that is not extremely acute, you can try applications of either ice or heat for 10 minutes each.  Another strategy is to try ice for 10 minutes, and then the heat pack for 10 minutes directly following.  Do whatever you believe yields the most relief.  The success of these strategies can vary patient to patient.  If symptoms increase with any of the above strategies, discontinue use.
  • Avoid prolonged postures and activities.  You will become familiar with your limits.  Be proactive instead of always being reactive.  For example, if you know that sitting longer than 15 minutes increases symptoms, then stand up after 10 minutes.
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  • Avoid bending, twisting, and lifting if you can.  If this is not possible for whatever reason, then try to minimize the amount of such movements and perform these movements very slowly.  Keep your back as straight as you can.  For example, when going from a seated to a standing position, rise up with your back straight.  Sit in a chair with armrests so you can use your arms to help you up, in addition to using your thigh muscles.
  • While standing upright, slide your right arm down the outside of your right leg to the right knee.  Hold for five seconds.  If you cannot go this far due to symptoms, then just go as far as not to exceed mild symptoms.  Do the same movements on your left side.  Perform these movements multiple times each day.  If these movements result in too much pain, however, then stop them but revisit these same exercises again a day or two later.
  • Try to do many short walks every day.  For example, try 10 walks per day at 5-10 minutes per walk or as tolerated.  Keep these walks at a normal or even slower-than-normal pace, depending upon your symptoms.  If walking results in too much pain, then discontinue, but revisit these walks again a day or two later.
  • Try to lie on your back facing up while sleeping.  However, if this position is too painful, then choose a sleeping position which is most comfortable.
  • Consider the possibility of conservative treatment (ie.  chiropractic therapy, physiotherapy)

Dr. Kevin Bloom is the newest contributor to For more information about Dr. Bloom, visit