How to treat lower back pain

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The American Association of Neurological Surgeons recommends that people contact a doctor if lower back pain does not improve after 2–3 weeks of treating it at home or if the pain worsens.

If people experience severe lower back pain after a recent injury, fall, or accident, they must see a doctor immediately.

People will also need to seek emergency medical care if any of the following symptoms accompany lower back pain:

• numbness and tingling
• weakness
• bowel or bladder problems

Read about some causes of lower back pain.

People can try the following techniques to ease lower back pain at home:

Hot and cold therapy

Applying a warm compress or heating pad to the back or having a warm bath may help increase blood flow and ease back pain.

Applying a cold compress helps lessen pain and swelling. People can use an ice pack, with a towel between the skin and pack, for 15–20 minutes.

Learn more about heat and cold therapy.

Massage

Massage may help ease back pain in the short term and has the added benefit of increasing a person’s sense of well-being.

A friend or loved one may be able to massage the lower back using various gliding and kneading motions. People could also try self-massage using a massage device.

Learn about deep tissue massage.

Topical pain relief

Pain-relief creams, gels, sprays, and patches are available over-the-counter (OTC) at pharmacies and online.

They contain various ingredients, such as menthol, CBD, or capsaicin, which create a numbing or warming sensation when a person rubs them into the skin.

Compare CBD creams for back pain.

If lower back pain does not resolve with home remedies, doctors may recommend the following treatments:

Medications

Medications for lower back pain include OTC or prescription drugs, such as:

• acetaminophen to relieve pain
• nonsteroidal anti-inflammatory drugs (NSAIDs) to decrease pain and swelling
• steroids, which people may take orally or have as an injection into the spine to reduce inflammation
• muscle relaxants, such as cyclobenzaprine, which people take orally

Physical therapy

A physical therapist can give people specific exercises to help strengthen the lower back and improve the range of motion. This may help reduce pain.

People can also use devices such as braces to help support the lower back. A brace wraps around the lower back and stomach to help provide stability and comfort. Braces are only suitable for temporary use.

A chiropractor may perform manipulation therapy to treat lower back pain. Spinal manipulation may result in small improvements in lower back pain and function.

Learn more about physical therapy.

Injections

Epidural steroid injections (ESIs) are a common treatment for lower back pain due to nerve compression.

A doctor will inject steroids and possibly a local anesthetic into the epidural space within the spinal canal. An ESI is a minimally invasive procedure.

Treatment with ESIs may provide short-term results, including:

• pain relief
• improved quality of life
• preventing or delaying the need for surgery

Learn more about ESIs.

Surgery

If nonsurgical treatment options for lower back pain have been ineffective for around 6–12 months, surgery may be an option for certain conditions.

Surgical options include:

• Spinal fusion: Spinal fusion joins two vertebrae to form one bone to prevent motion from causing pain.
• Disk replacement: A disk replacement removes a disk in the lower back and replaces it with an artificial disk. Doctors use this to try and retain flexibility and motion in the spine.
• Diskectomy: A diskectomy removes a damaged section of a herniated disk. This procedure relieves nerve compression and may be a treatment for sciatica.
• Laminectomy: A laminectomy removes any bone spurs or thickened ligaments that may be pressing on nerves and causing lower back pain.
• Vertebroplasty: A vertebroplasty, or kyphoplasty, stabilizes a compression fracture by injecting cement into the fracture. This helps relieve pain and stabilizes the bone.

Learn about Medicare coverage for back surgery.

The National Center for Complementary and Integrative Health notes low to moderate evidence that mind-body therapies may relieve chronic lower back pain.

Complementary therapies include:

• acupuncture
• low level laser therapy
• mindfulness-based stress reduction
• electromyography biofeedback
• progressive muscle relaxation
• tai chi
• yoga

Read about 11 ways to treat back pain without surgery.

The duration of lower back pain may depend on the underlying cause. According to the National Institute of Neurological Disorders and Stroke, back pain can be acute or chronic.

Acute back pain is short-term and may last a few days or weeks. People can treat acute back pain with home remedies and self-care without further treatment. Acute back pain does not affect function in the long term.

Chronic back pain lasts for 12 weeks or more. The pain continues after a person receives treatment for the underlying cause or injury.

Read more about chronic lower back pain.

Below are answers to some common questions about lower back pain.

Is sitting or lying down with lower back pain better?

According to a 2020 study, sitting for long periods without proper support may put extra pressure on the joints and lead to pain. Sleeping on the side in a fetal position, on a firm surface, may help ease pressure on the back and open up joints in the spine. The Arthritis Foundation recommends resting moderately and engaging in regular, gentle movement to help with back pain. Doctors discourage prolonged bed rest.

What causes sudden severe lower back pain?

Severe, sudden back pain may occur due to:

• an accident, injury, or fall
• lifting something heavy
• nerve pain

People may be able to treat lower back pain at home with hot and cold therapies, massage, and topical pain relief. Complementary therapies may also help reduce pain and prevent pain in the future.

Sometimes, people may require medications, steroid injections, or physical therapy. Chronic pain that does not respond to treatment may require surgery.