General recommendations are to gradually increase your activity to tolerance as soon as possible. Bed rest is usually not advised for more than a day or two. Stretching or activities that place additional strain on the back are also discouraged.
Sleeping with a pillow between the knees while lying on one side may increase comfort. Some doctors recommend lying on your back with a pillow under your knees.
No specific back exercises have been found that improve pain or increase functional ability in people with acute back pain. Exercise, however, may be useful for people with chronic back pain to help them return to normal activities and work.
Nonprescription medications may provide relief from pain.
Ibuprofen (Advil, Nuprin, Motrin) is an excellent medication for the short-term treatment of low back pain. Because of the risk of ulcers and gastrointestinal bleeding, talk with your doctor before using these medications, especially if you have any medical problems or take any other medicines.
Topical agents such as “deep heating rubs” may provide relief for some people.
Some people seem to benefit from the use of ice or heat. Take care: Do not use a heating pad on "high" or place ice directly on the skin.
Most experts agree that prolonged bed rest is associated with a longer recovery period. Further, people on bed rest are more likely to develop depression, blood clots in the legs, and decreased muscle tone. Very few experts recommend more than a 48-hour period of decreased activity or bed rest. In other words, get up and get moving to the extent you can.
Internal bleeding is one of the most serious consequences of trauma. Usually, the bleeding results from obvious injuries that require rapid medical attention. Internal bleeding may also occur after a less severe trauma or be delayed by hours or days. Some internal bleeding due to trauma stops on its own. If the bleeding continues or is severe, surgery is required to correct it.
Initial treatment of low back pain is based on the assumption that the pain in about 90% of people will go away on its own in about a month. Many different treatment options are available. Some of them have been proven to work. Others are of more questionable use.
Home care is recommended for the initial treatment of low back pain. Bed rest remains of unproven value, and most experts recommend no more than two days of bed rest or decreased activity. Application of local ice and heat provide relief for some people and should be tried. Acetaminophen and ibuprofen are useful for controlling pain.
For any given person, it is not known if a particular therapy will provide benefit until it is tried. Your doctor may try treatments known to be helpful in the past.
If back pain is associated with sudden loss of bladder or bowel control, weakness, or paralysis it is important to seek immediate medical attention.