Most Lower back pain will not require surgery. Most treatments involve reduction of the inflammation, restoring proper function and strength to the back which helps to prevent a recurrence of the injury. If after 72 hours you do not notice a reduction in pain and inflammation, you should contact you health care professional.
Although never scientifically proven, hot and cold compresses may help to quickly resolve low back injury and allow great mobility in some individuals. When using a cold compress, the patient should apply a cold pack such as a bag of vegetables or ice wrapped in a towel as soon as possible following the trauma that caused the lower back pain. Apply the cold compress to the to the affect lower back pain spot several times a day for up to 20 minutes. Use this cold compress technique for 2 or 3 days and then switch to a hot compress technique. Applying heat from a heating pad or lamp for brief periods helps to relax muscles and increase blood flow. Patients using a heating pad should avoid sleeping on it as this can lead to burns and additional tissue damage.
Bed rest ? 1'2 days at most. A 1996 Finnish study found that persons who continued their activities without bed rest following onset of low back pain appeared to have better back flexibility than those who rested in bed for a week. Other studies suggest that bed rest alone may make back pain worse and can lead to secondary complications such as depression, decreased muscle tone, and blood clots in the legs. Patients should resume activities as soon as possible. At night or during rest, patients should lie on one side, with a pillow between the knees (some doctors suggest resting on the back and putting a pillow beneath the knees).
Exercise may be the most effective way to speed recovery from low back pain and help strengthen back and abdominal muscles. Maintaining and building muscle strength is particularly important for persons with skeletal irregularities. Doctors and physical therapists can provide a list of gentle exercises that help keep muscles moving and speed the recovery process. A routine of back-healthy activities may include stretching exercises, swimming, walking, and movement therapy to improve coordination and develop proper posture and muscle balance. Yoga is another way to gently stretch muscles and ease pain. Any mild discomfort felt at the start of these exercises should disappear as muscles become stronger. But if pain is more than mild and lasts more than 15 minutes during exercise, patients should stop exercising and contact a doctor.
Medications are often used to treat acute and chronic low back pain. Effective pain relief may involve a combination of prescription drugs and over-the-counter remedies. Patients should always check with a doctor before taking drugs for pain relief. Certain medicines, even those sold over the counter, are unsafe during pregnancy, may conflict with other medications, may cause side effects including drowsiness, or may lead to liver damage.
Over-the-counter analgesics, including nonsteroidal anti-inflammatory drugs (aspirin, naproxen, and ibuprofen), are taken orally to reduce stiffness, swelling, and inflammation and to ease mild to moderate low back pain. Counter-irritants applied topically to the skin as a cream or spray stimulate the nerve endings in the skin to provide feelings of warmth or cold and dull the sense of pain. Topical analgesics can also reduce inflammation and stimulate blood flow. Many of these compounds contain salicylates, the same ingredient found in oral pain medications containing aspirin.
Anticonvulsants ? drugs primarily used to treat seizures ? may be useful in treating certain types of nerve pain and may also be prescribed with analgesics.
Some antidepressants, particularly tricyclic antidepressants such as amitriptyline and desipramine, have been shown to relieve pain (independent of their effect on depression) and assist with sleep. Antidepressants alter levels of brain chemicals to elevate mood and dull pain signals. Many of the new antidepressants, such as the selective serotonin reuptake inhibitors, are being studied for their effectiveness in pain relief.
Opioids such as codeine, oxycodone, hydrocodone, and morphine are often prescribed to manage severe acute and chronic back pain but should be used only for a short period of time and under a physician's supervision. Side effects can include drowsiness, decreased reaction time, impaired judgment, and potential for addiction. Many specialists are convinced that chronic use of these drugs is detrimental to the back pain patient, adding to depression and even increasing pain.
Acupuncture involves the insertion of needles the width of a human hair along precise points throughout the body. Practitioners believe this process triggers the release of naturally occurring painkilling molecules called peptides and keeps the body's normal flow of energy unblocked. Clinical studies are measuring the effectiveness of acupuncture in comparison to more conventional procedures in the treatment of acute low back pain.
Biofeedback is used to treat many acute pain problems, most notably back pain and headache. Using a special electronic machine, the patient is trained to become aware of, to follow, and to gain control over certain bodily functions, including muscle tension, heart rate, and skin temperature (by controlling local blood flow patterns). The patient can then learn to effect a change in his or her response to pain, for example, by using relaxation techniques. Biofeedback is often used in combination with other treatment methods, generally without side effects.
Ultrasound is a noninvasive therapy used to warm the body's internal tissues, which causes muscles to relax. Sound waves pass through the skin and into the injured muscles and other soft tissues. When a condition does not respond to conventional therapies, and it is serious enough, then surgery is to be considered. It is best to discuss this option with a health professional before undertaking any serious procedure. Since invasive back surgery is not always successful, only patients with progressive neurologic disease or damage to the peripheral nerves should have this done.
Lets look at a few noninvasive techniques that can help to alleviate lower back pain.
Foraminotomy: this is an arthroscopic approach to open up the foramen without the need for general anesthesia in an outpatient surgical setting. A foraminotomy is a medical operation used to relieve pressure on nerves that are being compressed by the intervertebral foramen, the space in the vertebra where a nerve root exits the spinal canal. A foraminotomy is performed to relieve the symptoms of nerve root compression in cases where the foramen is being compressed by bone, disc, scar tissue, or excessive ligament development and results in a pinched nerve.
Laminotomy

This is an arthroscopic approach to laminotomies used to open up the spinal canal, without the need for general anesthesia, in an outpatient surgical setting. A laminotomy is a surgical procedure that is used to relieve pressure off the spinal canal for the exiting nerve root and spinal cord, increasing the amount of space available for the neural tissue and thus releasing the nerve(s). The term laminotomy is derived from the Latin words lamina (bony plate that covers the posterior arch of the vertebra) and -otomy (act of cutting, incision).
Percutaneous Arthoroscopic Discectomy
Percutaneous Discectomy is the surgical removal of herniated disc/bulging disc material that presses on a nerve root or the spinal cord.
Facet Thermal Ablation
A Facet Thermal Ablation is a procedure very similar to a root canal a dentist performs. The surgeon uses a laser to clean the facet joint and deaden the nerve that innervates the joint and causes painful symptoms. The facet joints are the joint structures that connect the vertebrae to one another. Thermal ablation refers to the laser eradication of the effected nerve.
A Facet Thermal Ablation is used to treat the following conditions:
Facet Disease
Facet Joint Syndrome
Facet Hypertrophy
Facet Arthritis
Degenerative Facet Joints