What Can Help My Back Pain?

How to get relief without relying on medication

Adam Rosenbluth, M.D.,

AARP

Comments

Published September 02, 2024

illustrated gif of a woman trying to get up from a chair

James Yates

I have terrible back pain, but my doctors won’t give me anything for the pain and say to be careful with over-the-counter meds. I pretty much have back pain all the time. What do you recommend?

This is a complicated problem, and it affects millions: More than 8 percent of Americans adults suffer from chronic and severe back pain. Getting around, being with family and friends, working and even self-care can be tough to manage when your back hurts.

And you’re right — prescribed pain medication is a limited option. These days doctors feel nervous writing prescriptions for pain medication because of the risks of overdose and addiction. Understandably, federal and state regulations now restrict when and how these controlled substances can be prescribed, and monitor doctors who prescribe them, in some rare cases even prosecuting them.

So we look to over-the-counter medications. These drugs can be wonderful, but if you take them too often, they can cause problems. For instance, Tylenol, or acetaminophen, can be toxic to the liver when taken over the recommended dose. Liver enzymes may rise, which indicates irritation, inflammation or damage to your liver.

On the other hand, if you take too many NSAIDS (nonsteroidal anti-inflammatory drugs) like aspirin, ibuprofen (brand names Advil, Motrin) and naproxen (brand name Aleve), blood vessels leading to your kidneys can narrow, causing issues like gastritis, stomach ulcers and bleeding.

That’s why physical therapy may be a good choice to help alleviate back pain. I will admit that in the past I undervalued the importance of PT. When I needed it myself, I struggled to make it to my appointments. I was working with two different therapists and, to be honest, neither really helped.

Then I met a third physical therapist who took a different approach. Now I’m 98 percent better — and grateful. My takeaway is that sometimes you have to check out more than one therapist — and you have to actually go to the appointments and do the recommended home exercises in order to see results.

You may have already seen your internist or gotten an opinion from an orthopedic surgeon or neurosurgeon and not been aware that there’s another option — a relatively new kind of specialist called a physiatrist. These doctors are often covered by insurance, look at the problem differently and offer a nonsurgical approach to orthopedic problems. They may diagnose your back pain as coming from another area of your body — your hip, knee or foot — that is more easily addressed. But in the end surgery may be your only answer.

Before you go there, you might want to check out specialized medical practices that are called spine pain management clinics. These are generally a group of anesthesiologists who deal specifically with back pain. They can inject a variety of anti-inflammatory medications, including steroids.

I know you may have tried exercise, but I’m going to encourage you to keep moving. A study published just this June in The Lancet reports that a walking program of at least 30 minutes a day, five days a week, can significantly reduce the recurrence of lower back pain. Walking can also help to keep weight down, which is another way to ease back pain.

More from Dr. Adam

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Help! How Can I Get My Doctor to Really Listen to Me During Appointments?

I’m Tired All the Time. Is There Something Wrong With Me?

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What if I Don’t Want to Get Weighed at the Doctor’s Office?

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Many patients have also had success with therapies that help with stress reduction and using a mind-body connection to address the psychological aspects of pain. I recommend the book Healing Back Pain: The Mind-Body Connection by John Sarno, M.D., to my patients.

One final note: Back pain can make getting a good night’s sleep even more difficult. Since sleep is critical for our overall health and mental well-being, try sleeping on your side and putting a pillow between your knees to keep your spine in a neutral position. If you prefer sleeping on your back, place the pillow under your knees.

I hope this helps you and I hope everyone who is suffering finds a way to ease their pain.

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