What is the treatment for back pain caused by lifting incorrectly?

Treatment for Back Pain Caused by Incorrect Lifting

For back pain caused by incorrect lifting, the most effective treatment approach is a combination of self-care strategies, appropriate medications, and targeted physical therapy, with specific exercises that strengthen the supporting muscles of the spine.

Initial Management (Acute Phase - First 4 Weeks)

Self-Care Strategies

• Remain active and avoid bed rest - Continuing normal activities within pain limits is crucial for recovery 1
• Apply heat to the affected area for pain relief 2
• Activity modification - Avoid positions that stretch hamstrings beyond comfortable range and limit hip flexion to 90° when possible 2
• Take regular breaks to change positions when sitting for prolonged periods 2

Pharmacological Treatment

• NSAIDs (first-line) for pain relief and anti-inflammatory effects 1, 2
  • Most effective when taken regularly for the first few days rather than as needed
• Muscle relaxants such as cyclobenzaprine for short-term use (up to 2-3 weeks) if muscle spasm is present 1, 3
  • Typical dosing: 5-10mg three times daily
  • Caution: May cause drowsiness; use with care in patients with hepatic impairment 3
• Acetaminophen may be considered but evidence for effectiveness is limited 4

Important Cautions

• Avoid opioids for routine management of acute back pain 1
• Avoid systemic corticosteroids as they have not been shown to be more effective than placebo 1
• Limit muscle relaxant use to short periods (2-3 weeks maximum) 3

Subacute Phase (4-8 Weeks)

If pain persists beyond 4 weeks:

Non-Pharmacological Approaches

• Spinal manipulation administered by providers with appropriate training shows small to moderate short-term benefits 1
• Exercise therapy should be initiated after the acute phase 1, 2
  • Motor control exercises that restore coordination, control, and strength of muscles supporting the spine 2
  • Progressive strengthening exercises focusing on core and back muscles 5
• Intensive interdisciplinary rehabilitation if available, which combines physical, psychological, and vocational components 1

For Weight Lifters or Those Who Need to Return to Lifting

• Technique modification is essential before returning to lifting activities 5
• Gradually reintroduce lifting with proper form, starting with lighter weights 5, 6
• Consider deadlift exercises as part of rehabilitation for those with lower pain levels and higher baseline lumbar extension strength 6

Chronic Phase (Beyond 12 Weeks)

If pain persists beyond 12 weeks:

Non-Pharmacological Options

• Acupuncture has shown moderate effectiveness 1
• Massage therapy provides short-term relief 1
• Yoga (particularly Viniyoga-style) can be beneficial 1
• Cognitive-behavioral therapy helps manage pain perception and response 1, 4

Advanced Pharmacological Options

• Duloxetine may be beneficial for chronic low back pain 4
• Gabapentin for nerve-related pain if radicular symptoms are present 2

When to Consider Imaging or Specialist Referral

• Immediate imaging is warranted only if there are:
  • Severe or progressive neurological deficits 2
  • Signs of serious underlying conditions (cancer, infection, cauda equina syndrome) 1, 2
• Delayed imaging (after 4-6 weeks) if:
  • Pain persists despite conservative management 2
  • Radicular symptoms are present 2

Common Pitfalls to Avoid

1. Rushing to imaging - Routine imaging for acute low back pain without red flags provides no clinical benefit and may lead to unnecessary interventions 2

2. Prolonged inactivity - Bed rest beyond 1-2 days can delay recovery and lead to deconditioning 1

3. Overreliance on passive treatments - Active approaches like exercise therapy show better long-term outcomes than passive modalities alone 1, 4

4. Returning to heavy lifting too soon - Gradual progression with proper technique is essential to prevent reinjury 5, 6

5. Ignoring psychosocial factors - Addressing fear-avoidance behaviors and catastrophizing is important for preventing chronic pain 4