What is the treatment for acute lower back strain?

From the Guidelines

Treatment for a thrown-out back typically involves nonpharmacologic treatment with superficial heat, massage, acupuncture, or spinal manipulation, as these methods have shown moderate to low-quality evidence of effectiveness in reducing pain and improving function 1. When it comes to managing the condition, the following steps can be taken:

• Rest for 24-48 hours, followed by gentle movement as tolerated
• Take over-the-counter pain medications like ibuprofen (400-800mg every 6-8 hours with food) or acetaminophen (500-1000mg every 6 hours) to reduce pain and inflammation, as recommended by the American College of Physicians guideline 1
• Apply ice for the first 48-72 hours (20 minutes on, 20 minutes off), then switch to heat therapy
• Gentle stretching exercises like knee-to-chest pulls and pelvic tilts can help once acute pain subsides
• Maintain good posture and avoid activities that worsen pain It's essential to note that if symptoms are severe or include leg weakness, numbness, or bladder/bowel problems, immediate medical attention should be sought. Most back injuries improve within 2-6 weeks with conservative treatment, and the pain typically results from muscle strain, ligament sprain, or minor disc issues 1. The recommended treatments help reduce inflammation, relax muscle spasms, and promote healing of the affected tissues while preventing further injury.

From the FDA Drug Label

Cyclobenzaprine hydrochloride tablets are indicated as an adjunct to rest and physical therapy for relief of muscle spasm associated with acute, painful musculoskeletal conditions The treatment for someone who has thrown their back out is cyclobenzaprine hydrochloride tablets as an adjunct to rest and physical therapy for relief of muscle spasm associated with acute, painful musculoskeletal conditions 2.

• The medication should be used only for short periods (up to two or three weeks)
• Improvement is manifested by relief of muscle spasm and its associated signs and symptoms, namely, pain, tenderness, limitation of motion, and restriction in activities of daily living 2.

From the Research

Treatment for Thrown Back

• The treatment for someone who has thrown their back out is not directly addressed in the provided studies, as they focus on ankle sprains and low back pain management.
• However, the study 3 discusses the use of medications for treating low back pain in adults, which may be relevant to thrown back treatment.
• According to 3, muscle relaxants and nonsteroidal anti-inflammatory drugs (NSAIDs) may be effective in reducing pain for acute low back pain.
• The study 3 also suggests that paracetamol, opioid analgesics, antibiotics, muscle relaxants, and antidepressants should only be prescribed after considering the risks and benefits and in conjunction with nonpharmacological strategies.
• The use of ice as a recovery strategy, discussed in 4 and 5, may not be directly applicable to thrown back treatment, but 5 suggests that ice can be used in the immediate acute stage following injury to reduce secondary tissue damage.

Non-Pharmacological Strategies

• While the provided studies do not directly address thrown back treatment, they emphasize the importance of individualized treatment decisions and consideration of nonpharmacological strategies.
• The study 3 recommends discussing treatment options with the patient and considering the risks and benefits of each option.
• The study 5 suggests tailoring the application of ice based on the injury timeline and repair process, which may be applicable to other treatment strategies.