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Once you’ve been diagnosed, your doctor can recommend a number of treatment options for you, based on your particular condition and lifestyle.

EXERCISE1

Depending on what’s causing your back pain, keeping active can improve your posture, the movement in your spine, and your overall pain and stiffness. Your doctor or physiotherapist may recommend that you follow an exercise programme that can help to restore the strength in your back. Always ask your healthcare provider before starting an exercise programme on your own.

MANUAL THERAPY1

If you have persistent pain, your doctor may recommend that you follow a course of physical therapy with a physiotherapist (see below), a chiropractor or an osteopath. All three are specialists in the movement and functioning of the body. Manual therapy may be recommended alongside medications.

PHYSIOTHERAPY1

Physiotherapy can help you learn how to recover movement that may have become restricted due to your back pain, and may take several approaches – including specific exercise programmes, manual therapy (such as massage) or hydrotherapy, which is exercise conducted in a warm pool of water that focuses on improving your range of movement or strength. Physiotherapists can also assess you and help you plan a good exercise programme.

ACUPUNCTURE1

Acupuncture involves inserting fine needles at specified points of the body.Acupuncture has been shown to be effective in treating back pain, by diverting pain impulses away from the your brain, so that you are less likely to feel the pain, and by stimulating the endorphins, the body's own pain-relieveing hormones.

BEHAVIOURAL THERAPY1

Cognitive behavioural therapy (CBT) is a technique that involves changing negative thoughts and behaviours into more positive ones. This technique can be used in combination with other therapies to help manage the psychological effects of your chronic back pain.

SURGERY1

Surgery is usually considered for specific back problems, if your back pain is triggered by a congenital deformity, or after other forms of therapy have been tried and your pain persists or worsens. In these cases, you may be referred to a specialist who will discuss the benefits and risks of surgical treatment options with you in detail.

MEDICATIONS

You may have already tried a painkiller purchased from your local pharmacy, and if this hasn’t reduced your symptoms, your doctor may prescribe other medications, or recommend a different dose.
The medications listed here may potentially cause side effects to differing degrees so it is important to discuss with your doctor which medication is best for your particular case.

NON-STEROIDAL ANTI-INFLAMMATORY DRUGS (NSAIDs)1,2

Anti-inflammatory drugs can help to relieve back pain, tenderness, inflammation and stiffness. NSAIDs can have some side effects, however, particularly if taken for a long time. Your doctor will discuss these with you and, together, you will be able to assess whether NSAIDs are right for you.

OTHER PAINKILLERS1,2

If your pain does not respond to other medications, your doctor may prescribe a different type of painkiller that is called an opioid. Opioids work by reducing pain signals from the spinal cord and other areas of the body to the brain. These medications may be used for more severe types of pain and your doctor can discuss your options and possible side effects, including the possibility of drug dependency, with you before writing a prescription.

INTRA-ARTICULAR STEROIDS2

Steroids play an important role in clinical practice for the treatment of autoimmune diseases. These drugs are, highly effective in treating inflammatory and immunological processes, with a rapid, marked effect on the symptoms. Steroids can have side effects, particularly if used frequently, and your doctor will discuss these with you and will want to monitor how often you use them.

BIOLOGICAL THERAPIES3

Also known as “biologics”, these are disease-modifying drugs that work on your immune system (the body’s natural defence system) by addressing underlying inflammation caused by certain diseases. Biological therapies can be effective in reducing pain and stiffness and are given as an injection under the skin or intravenously under the supervision of a healthcare professional. These medications are not suitable for everybody and can cause some serious side effects. Your doctor will be able to decide whether these medications may be right for you.

ANTIBIOTICS4

If your doctor thinks that your pain might be due to an infection, he/she may prescribe an antibiotic. If you have an infection in an area in or around your spine antibiotic treatment can be an effective way of treating you and relieving your pain.

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BACK PAIN
SYMPTOM CHECKER​

There are different types of back pain and it's important to find out which type of pain you have as early as possible, so it can be managed appropriately. If you have had back pain for more than 3 months, you should complete our short Symptom Checker to help you and your doctor understand if your back pain is more likely to be inflammatory.

REFERENCES

  1. Airaksinen O, et al. Chapter 4. European guidelines for the management of chronic nonspecific low back pain. Eur Spine J. 2006;15(Suppl. 2):S192–S300.
  2. Da Silva JAP, Woolf AD (Eds). Rheumatology in practice. Chapter 11:167-199; Chapter 24:392-405; Chapter 30:506-516.
  3. National Institute for Health and Care Excellence (NICE). Adalimumab, etanercept and infliximab for ankylosing spondylitis. May 2008
  4. Albert HB, et al. Antibiotic treatment in patients with chronic low back pain and vertebral bone edema (Modic type 1 changes): a double-blind randomized clinical controlled trial of efficacy. Eur Spine J. 2013;22:697–707.