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Caring for Your Back and Neck

First 48-72 hours

• Ice (15-20 minutes, 3-4 times per day)
• Acetaminophen
• Rest from painful activities
• Walk or perform other low stress exercise
• Minimal bed rest

After 72 hours

• Moist heat 15-20 minutes, before exercising

• Back, abdominal, and hip stretching exercises

• Back and abdominal strengthening exercises

• Aspirin or Ibuprofen

Using Ice and Heat
To relieve initial pain, you can supply an ice pack for 15-20 minutes every two hours for the first 72 hours. Avoid lying on the ice pack, as it could freeze the skin. After the first 72 hours, moist heat, such as a hot shower, bath, wet towels, or hot water bottle, may help relax muscles prior to stretching exercises. Apply 15-20 minutes every few hours.

Massage
Massage helps increase the blood flow to your muscles and helps muscles relax. You may want to consult a massage therapist for assistance.

Medication
Acetaminophen, ibuprofen, and aspirin can help reduce pain. Follow the label for recommended dosages and frequency. Inform your doctor of any drug allergies or adverse reactions.

Rest
Rest from painful activities, but resume daily activities such as walking as quickly as possible. Muscles and other tissues will stiffen and weaken if you avoid exercise for too long.

Exercise
As pain decreases, try the exercises in this brochure. Slight discomfort is normal. Gradually increase the amount, intensity, and frequency of exercise as tolerated. If you experience severe or prolonged pain, stop and seek medical help. Also stop and seek help if exercises cause numbness or tingling in your arms or legs.

Stress and Tension Management
Muscular relaxation and breathing exercises, meditation, and guided imagery may help relax tense muscles and relieve pain. Listening to soothing music and resting your body and mind may help as well.

Recreational Activities
Some activities, like swimming, walking and water exercise, can help tone and stretch muscles while you recover. However, aggressive twisting, bending and weight bearing activities (like tennis, golf, bowling, racquetball, diving, jogging, and high-impact aerobics) can increase back problems. Therefore, only attempt strenuous activities once your symptoms subside and strength, flexibility and conditioning are restored.

Seeking Help
If your pain worsens or does not decrease after two weeks of self-care, or you have questions or concerns about your back or neck, call your doctor. Evaluation of your problem may include a discussion and review of your medical history, a physical examination and diagnostic tests.

To ensure that all of your concerns and questions are addressed, prepare for your appointment. You may want to take a written, chronological history of your problem with accurate descriptions of your symptoms. You may also want to prepare a list of questions.

Ask your provider to explain the advantages and disadvantages of all tests and procedures. Be sure to ask them the expected outcomes of different treatments such as drug therapy, physical therapy, or surgery. If you are scheduled for tests or additional consultation, investigate the costs that you may incur. Talk to your provider about payment expectations and if you have coverage with your insurance company about filing a claim.

Summary
You are not alone if you suffer from back and neck pain or related problems. Performing exercises can help restore your body to optimal health, prevent back and neck pain, and reduce the risk of re-injury.

References
¹American College Health Association. National College Health Assessment: Reference Group Executive Summary Spring 2000. Baltimore: American College Health Association; 2001.

²Warner M, Barnes, PM, and Fingerhut, LA. Injury and poisoning episodes and conditions; National Health Interview Survey, 1997. Vital Health Statistics 10(202). 2000.

³Nachemson, AL. Chronic Pain: The end of the welfare state? Quality Life Research (1994). 3:S11-7.

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