Chronic back pain 

Most lower back pain resolves itself in less than a month's time, without any treatment. But what to do if it doesn't? Here are some things I've learned over the years to make my pain less intrusive.

Note: This site has been superceded by the Less Back Pain blog. 

Lumbar support

The McKenzie book stresses the importance of good posture and good lumbar support. They sell a polyurethane lumbar role, which you place in just above the beltline when you sit. This can make sitting more comfortable. There are other more low tech (and high tech) lumbar supports however, with various advantages. Here's a complete list:

  1. Mckenzie Lumbar Roll  Pro: strap makes it easy to carry. Made of foam that is soft and small enough that you can use it for extended periods of time without strain. Con: sometimes it is not big enough to provide sufficient support.  The foam wears out after a while (expect to replace it every year).
  2. Paper towel role. I prefer the smaller size that typically costs about $1. For it's cost, there's really nothing that comes close, and since it doesn't compress as much as the McKenzie role, it can be better in some situations (such as in a car with very poor lumbar support in the seats). Be sure to keep the wrapper on so it holds together.
  3. 2 pound bag of frozen peas. Aside from the fact that they melt and the bag will eventually leak, there's no better lumbar support. The peas are just right combination of cold, size, and flexibility. But, at most the bag will last an hour before it will urgently need to be put back into the freezer. I like to use these at home, such as when sitting down for a meal. You can reuse the bag if you freeze it again, but after enough reuses the peas will tend to freeze into a solid brick, which doesn't work so well. I find that the bag leaks a lot less if you wrap it in one or two plastic shopping bags.
  4. Rubbermaid ice blanket ($2.50 at Target). Frozen peas are great, but they melt. The ice blanket does too, but without the mess. The package is not as flexible as a bag of peas, so it may be slightly less good ergonomically. On the other hand, having a package that lasts half a day, and doesn't need to be refrozen immediately is a big advantage. I like to combine one whole blanket with 2/3rds of a blanket, and then wrap the whole thing in some cloth, as otherwise it gets way too cold.  Note that sometimes the blankets leak, so a plastic bag or two around the outside would be wise.

 

Exercises and stretching

There are lots of recommended stretching and exercising programs. Some are mutually exclusive, such as flexion stretches vs extension stretches. You will likely hear many repeated claims of this or that magic stretching program that reversed person X's chronic back pain. Keep in mind that back pain tends to go away with time, so the real cause may not be the stretching. Also consider that there are multiple causes of back pain, and one program of stretching and exercise is unlikely to be right for all sufferers. That said, keeping limber and fit will no doubt help your problems, as long as you don't overdo it. Studies have found that doing physical therapy can actually be worse than just maintaining a relatively active life following a back injury. The implication is that people are overdoing the exercise, and actually exacerbating the problem, whereas with normal activity such as walking this is less likely to happen. In my life, I've found that I tend to have more periods that are relatively pain free when I elect to keep my special exercises to a minimum, and just go on a lot of long walks. I suspect that an active life combined with a very careful regimen of stretching would be even better for me, but empirical evidence suggests that I haven't found the proper conservative level of stretching and back specific exercises that is safe for me.  

With that fairly lengthy disclaimer and warning, here are some links to exercises for lower back pain. Don't overdo them, but do give them a try.

Traditional back pain stretches - this is what you would likely see on one of those photocopied handouts your dr would give you the first time you come in complaining of back pain.