Tips for Managing Back or Neck Pain
About 80% of us will have back or neck pain at some point in our lives. The good news is that most of us will not need surgery or advanced imaging, such as MRI. In most cases, symptoms improve with time, movement and gentle therapies.
Start with your primary care provider
Ask yourself these questions and share this information with your doctor:
- Where is your pain? Does it come and go, or is it always there? Does it wake you up at night?
- Does the pain travel down an arm or leg?
- What makes your pain worse? What makes it better?
- Do you have any NEW numbness or tingling? If you have numbness in the saddle area (where you would sit on a horse) or when wiping with toilet paper, tell your doctor right away.
- Do you have any NEW weakness – e.g., trouble with lifting your foot, gripping things (or dropping things more often) or falling?
- Do you have any NEW trouble emptying your bladder or making it to the bathroom in time?
Try these tips for minor back or neck pain
Most of the time, starting with exercises and non-opioid pain medications can help.
Here are some things you can try at home:
- Ice. Applying ice can reduce swelling and pain in the first two to three days after an injury. Use ice for 20 minutes at a time. Repeat every two to three hours as needed. Do not apply ice directly to your skin – use a pillowcase or towel between the ice and your skin.
- Heat. Applying heat can help relax your muscles and increase blood flow to the area. The latest studies show that using heat right away on a new injury can help avoid a prolonged recovery. Use heat for 20 minutes at a time. You may repeat several times a day or alternate between heat and ice. Do not apply heat over a medication patch, and avoid lying on a heating pad, which could burn your skin – especially if you fall asleep.
- Over-the-counter pain medications and creams. Acetaminophen (Tylenol) and NSAIDS (ibuprofen, Advil, Aleve, etc.) can help manage pain. Read the label to find out how much you can take safely and how often. Some patients also find relief with capsaicin cream or CBD cream.
- Pillows. When lying on your back, try putting a pillow under your knees to relieve back strain. When lying on your side, a pillow between your legs may help. For neck pain, try using a different pillow or putting pillows under your arms.
- Sleep. Try to get at least seven hours of sleep per night and keep a consistent sleep schedule.
- Do not smoke. Studies suggest that people who smoke are nearly three times more likely to develop chronic back pain, due to decreased circulation and other factors. If you smoke or use nicotine products, get help to stop.
Experts agree that movement helps decrease back pain, while prolonged sitting or lying down can make it worse – so get up and move frequently. If you have recently hurt your back or neck, gentle movement may help you feel more comfortable.
If you have not been exercising, start slowly and keep it up. You can start by walking 10 minutes at a time, riding a stationary bike or walking in a pool. As you get stronger, you will be able to exercise longer.
Strengthening your core muscles (belly, mid- and lower back) may also improve back pain. Some discomfort is normal as you start moving, but if you have a lot more pain, talk to your primary care provider or ask to see a physical therapist or physiatrist (a doctor who specializes in body movement issues).
Don’t ignore serious symptoms – get help right away
Go to the nearest emergency department or urgent care if you have any of these symptoms:
- Loss of bowel control (more than one episode)
- Difficulty urinating or controlling urine (more than one episode)
- Rapidly progressing weakness or paralysis in your arm or leg that is new or getting worse
- Fever with significant back pain
Contact your doctor immediately and seek medical attention if you have:
- Sudden, severe worsening of back pain
- Unexplained weight loss with back pain
- Mild weakness in one or more limbs with neck or low back pain