Articles on musculoskeletal causes of back pain

Low Back Pain: What All You Must Know

Dr. (Maj) Pankaj N Surange, Spine and Pain Specialist
Back pain is a problem which is very often faced by all the human beings at least once in their lifetime. This pain, if not taken seriously can turn into a deadly disease which can put your life at stake.Some important facts about back painLow back pain is the most common musculoskeletal complaint, with potentially devastating consequences.90% of patients with acute low back pain do not require surgery. Most specialists agree that non-surgical treatment should be tried first. Surgery as first line treatment is indicated only in few selected cases. These are medical emergencies such as a broken neck or if you have symptoms such as weakness in the legs that gets progressively worse and/or bladder and/or bowel incontinence caused by the back problem.The incidence of back pain is highest between the ages of 35 and 55.Disc is not always the culprit. Small joints of spine are the source of pain in majority of patients.The pain combined with depression and anxiety in long-term cases places sufferers at risk for suicide.People who work at sedentary occupations are at a higher risk of disk injury than those who do moderate amounts of physical work.Up to 85 per cent of persons with back pain can’t recall a specific incident that brought on their pain.Early interventional treatments in back pain management have been found to return patients to work and regular activities more rapidly than past conservative therapies.Early intervention decreases unnecessary chronic pain, long-term treatments and disabilities.Heat and massage therapy cannot cure the disease. These do not provide long term solutions to the problems of back. These are mainly used for managing pain during the recovery period.Newer Developments and Better Understanding in Management of Back painA wide range of treatment is available for low back pain, depending on what is causing the pain and how long it lasts.Most people find that their low back pain improves within a few weeks. Chances are good that your pain will go away soon with some basic self-care.If you have recently developed low back pain, stay active and consider taking over-the-counter pain medicines .Staying active is better for you than bed rest. In fact, staying in bed more than 1 or 2 days can actually make your pain worse and lead to other problems such as stiff joints and muscle weakness.If your low back pain has lasted longer than 3 months, you will probably benefit from more intensive treatment.Must visit Interventional pain and spine specialist :-If you have moderate to severe low back pain that lasts more than a couple of Days;If you have back or leg symptoms that have gotten worse; If your symptoms have not gone away after 2 weeks of home treatment; Or, if improved symptoms flare up again.A physical examination by pain specialist and possibly an imaging (x-ray/MRI) test may produce new information about your condition and help direct your treatment decisions.Physical Therapy: TENS, UltrasoundHeat and Cryotherapy:These Modalities should always be considered an adjunct to an active treatment program in the management of acute low back pain. They should never be used as the sole method of treatment.Interventions: Minimally invasive non surgical procedures for management of Back PainFor back pain sufferers, interventional pain management techniques can be particularly useful. In addition to a thorough medical history and physical examination, interventional pain management physicians have a wide array of treatments that can be used including the following: Epidural injections (in all areas of the spine):The use of anesthetic and anti-inflammatory medications injected into the epidural space to relieve pain or diagnose a specific condition.Nerve, root, and median branch blocks:Injections done to determine if a specific spinal nerve root is the source of pain. Blocks also can be used to reduce inflammation and pain. Facet joint injections: An injection used to determine if the facet joints are the source of pain. These injections can also provide pain relief. Discography:An "inside" look into the discs to determine if they are the source of a patient's pain. This procedure involves the use of a dye that is injected into a disc and then examined using x-ray or CT Scan.Pulsed Radiofrequency otomy (PRFN): A minimally invasive procedure that disables spinal nerves and prevents them from transmitting pain signals to the brain. Rhizotomy:A procedure in which pain signals are "turned off" through the use of heated electrodes that are applied to specific nerves that carry pain signals to the brain. Spinal cord stimulation:The use of electrical impulses that are used to block pain from being perceived in the brain. Intrathecal pumps: A surgically implanted pump that delivers pain medications to the precise location in the spine where the pain is located. Percutaneous Discectomy / Nucleoplasty:A minimally invasive day care procedure in which tissue is removed from the disc with the help of decompressor through a very minute hole ,in order to decompress and relieve pressure on the spinal nerves. Ozoneucleolysis or Ozone discectomy: Has emerged as an affordable, least invasive approach and costs 2/3rd of the price of conventional surgery. Ozone injected inside the affected intervertebral disc under c- arm guidance, causes shrinkage of disc and thus, reducing the volume and lessening the pressure on nerves.Intradiscal Electrothermoplasty (IDET) This procedure involves the insertion of a needle into the affected disc with the guidance of an x-ray machine. A wire is then threaded down through the needle and into the disc until it lies along the inner wall of the annulus. The wire is then heated which destroys the small nerve fibers that have grown into the cracks and have invaded the degenerating disc. These techniques are exciting. They offer the possibility of treating low back pain and sciatica with much less trauma and risk than surgery.Quick tips to a healthier backFollowing any period of prolonged inactivity, begin a program of regular low-impact exercises. Speed walking, swimming, or stationary bike riding 30 minutes a day can increase muscle strength and flexibility.Yoga can also help stretch and strengthen muscles and improve postureAlways stretch before exercise or other strenuous physical activity. Don’t slouch when standing or sitting. When standing, keep your weight balanced on your feet. Your back supports weight most easily when curvature is reduced. At home or work, make sure your work surface is at a comfortable height for you. Sit in a chair with good lumbar support and proper position and height for the task.Keep your shoulders back. Switch sitting positions often and periodically walk around the office or gently stretch muscles to relieve tension. A pillow or rolled-up towel placed behind the small of your back can provide some lumbar support. If you must sit for a long period of time, rest your feet on a low stool or a stack of books. Wear comfortable, low-heeled shoes. Sleep on your side to reduce any curve in your spine. Always sleep on a firm surface.Ask for help when transferring an ill or injured family member from a reclining to a sitting position or when moving the patient from a chair to a bed. Don’t try to lift objects too heavy for you. Lift with your knees, pull in your stomach muscles, and keep your head down and in line with your straight back. Keep the object close to your body. Do not twist when lifting. Maintain proper nutrition and diet to reduce and prevent excessive weight, especially weight around the waistline that taxes lower back muscles. If you smoke, quit. Smoking reduces blood flow to the lower spine and causes the spinal discs to degenerate.

Myths and Facts About Low Back Pain

Dr. (Maj) Pankaj N Surange, Spine and Pain Specialist
· Low back pain is the most common musculoskeletal complaint, with potentially devastating consequences.· 90%of patients with acute low back pain do not require surgery. Most specialists agree that non-surgical treatment should be tried first.· Surgery as first line treatment is indicated only in few selected cases. These are medical emergencies such as a broken neck or if you have symptoms such as weakness in the legs that gets progressively worse and/or bladder and/or bowel incontinence caused by the back problem.· The incidence of back pain is highest between the ages of 35 and 55.· Disc is not always the culprit. Small joints of spine are the source of pain in majority of patients.· The pain combined with depression and anxiety in long-term cases places sufferers at risk for suicide.· People who work at sedentary occupations are at a higher risk of disk injury than those who do moderate amounts of physical work.· Up to 85 per cent of persons with back pain can’t recall a specific incident that brought on their pain.· Early interventional treatments in Back pain management have been found to return patients to work and regular activities more rapidly than past conservative therapies.· Early intervention decreases unnecessary chronic pain, long-term treatments and disabilities.· Heat and massage therapy cannot cure the disease. These do not provide long term solutions to the problems of back. These are mainly used for managing pain during the recovery period.NewerDevelopments and Better Understanding in Management of Back painA wide range of treatment is available for low back pain, depending on what is causing the pain and how long it lasts. Most people find that their low back pain improves within a few weeks. Chances are good that your pain will go away soon with some basic self-care.· If you have recently developed low back pain, stay active and consider taking over-the-counter pain medicines .· Staying active is better for you than bed rest. In fact, staying in bed more than 1 or 2 days can actually make your pain worse and lead to other problems such as stiff joints and muscle weakness.· If your low back pain has lasted longer than 3 months, you will probably benefit from more intensive treatment.· Must visit Interventional pain and spine specialist :-· if you have moderate to severe low back pain that lasts more than a couple of days;· if you have back or leg symptoms that have gotten worse;· if your symptoms have not gone away after 2 weeks of home treatment;· or if improved symptoms flare up again.·  A physical examination by pain specialist and possibly an imaging(x-ray/MRI) test may produce new information about your condition and help direct your treatment decisions.· Physical Therapy: TENS, Ultrasound, Heat and Cryotherapy:o These modalities should always be considered an adjunct to an active treatment program in the management of acute low back pain.o They should never be used as the sole method of treatment.Interventions: Minimally invasive non surgical procedures for management of Back PainFor back pain sufferers, interventional pain management techniques can be particularly useful. In addition to a thorough medical history and physical examination, interventional pain management physicians have a wide array of treatments that can be used including the following: Epidural injections (in all areas of the spine):The use of anesthetic and anti-inflammatory medications injected into the epidural space to relieve pain or diagnose a specific condition. Nerve, root, and median branch blocks:Injections done to determine if a specific spinal nerve root is the source of pain. Blocks also can be used to reduce inflammation and pain.Facet joint injections:An injection used to determine if the facet joints are the source of pain.These injections can also provide pain relief. Discography:An "inside" look into the discs to determine if they are the source of a patient's pain. This procedure involves the use of a dye that is injected into a disc and then examined using x-ray or CT Scan.Pulsed Radio frequency Neurotomy (PRFN): A minimally invasive procedure that disables spinal nerves and prevents them from transmitting pain signals to the brain. Rhizotomy:A procedure in which pain signals are "turned off" through the use of heated electrodes that are applied to specific nerves that carry pain signals to the brain. Spinal cord stimulation:The use of electrical impulses that are used to block pain from being perceived in the brain. Intrathecal pumps: A surgically implanted pump that delivers pain medications to the precise location in the spine where the pain is located. Percutaneous Discectomy / Nucleoplasty:A minimally invasive day care procedure in which tissue is removed from the disc with the help of decompressor through a very minute hole ,in order to decompress and relieve pressure on the spinal nerves. Ozoneucleolysis or Ozone discectomy: Has emerged as an affordable, least invasive approach and costs 2/3 of the price of conventional surgery. Ozone injected inside the affected intervertebral disc under c- arm guidance, causes shrinkage of disc and thus reducing the volume and lessening the pressure on nerves.These techniques are exciting. They offer the possibility of treating low back pain and sciatica with much less trauma and risk than surgery.Following any period of prolonged inactivity, begin a program of regular low-impact exercises:· Speed walking, swimming, or stationary bike riding 30 minutes a day can increase muscle strength and flexibility.· Yoga can also help stretch and strengthen muscles and improve posture· Always stretch before exercise or other strenuous physical activity.· Don’t slouch when standing or sitting.When standing, keep your weight balanced on your feet. Your back supports weight most easily when curvature is reduced.· At home or work, make sure your work surface is at a comfortable height for you.· Sit in a chair with good lumbar support and proper position and height for the task. Keep your shoulders back. Switch sitting positions often and periodically walk around the office or gently stretch muscles to relieve tension. A pillow or rolled-up towel placed behind the small of your back can provide some lumbar support. If you must sit for along period of time, rest your feet on a low stool or a stack of books.· Wear comfortable, low-heeled shoes.· Sleep on your side to reduce any curve in your spine. Always sleep on a firm surface.· Ask for help when transferring an ill or injured family member from a reclining to a sitting position or when moving the patient from a chair to a bed.· Don’t try to lift objects too heavy for you. Lift with your knees, pull in your stomach muscles, and keep your head down and in line with your straight back. Keep the object close to your body.Do not twist when lifting.· Maintain proper nutrition and diet to reduce and prevent excessive weight, especially weight around the waistline that taxes lower back muscles.· If you smoke, quit. Smoking reduces blood flow to the lower spine and causes the spinal discs to degenerate.

Three Tips to Reduce Back Pain as You Grow Older

Dr. Jyotsna Gupta, Gynecologist/Obstetrician
As you get older, your back needs attention. Here are some tips to help you reduce back pain.TIP 1 - RIGHT NUTRITION Right nutrition is most essential requirement for back pain. nutrition is provide by sufficient nutrient which gives strengthen to our musculoskeletal system of body. Nutrient which provide sufficient nutrition are:-TIP 2 - REGULAR EXERCISE  FOR BACK Extra weight means extra stress on your body , which lead to back pain .for those that carry weight in the belly region, the strain on the back  only increases. Find an eating plan that works for you, and get your  BMI under control. As we can see today,most of our activities are sedentary which does not strengthen up our back muscles rather they weaken them. It is even more necessary to exercise regularly. But make sure to try it with the guidance of an expert. (Either a PT or Yoga therapist.Regular exercise builds up the strength of our musculature, mobilises & lubricates our joints and improves the flexibility the most required.Not just that even the nourishment to our musculoskeletal system improves with an improved blood circulation.The different activities which help our spine and back to strengthen can be - yogic asanas, sun-salutations(for those who can), swimming, cycling and walking.TIP 3 - RIGHT POSTUREAs all of us know that we spend lots of time through the day sitting for most of the activities.so it is apparent that your back takes the burden of sitting most of time. If a right posture is maintained, it can prevent of our back problems.Make sure to let your spine take its natural curvature while sitting. you need to keep in mind proper spine alignment not just when watching TV or sitting at your desk at work. The position you sleep in can go in wrong way keeping back pain occur. the best position is on your side in a relaxed fetal position with your knee bent .place a pillow between your legs, so that as you sleep, the top leg does not slide forward, causing a twist in your lower back .consider also using a small pillow under your neck, so that your spine stay in alignment as much as possible. Remember to focus on your small daily movements, such as how you pick up objects (always bend at the knees)how you carry your purse or backpack(make sure it’s not too heavy and wear your backpack on both shoulder), invest in a new mattress or/and pillow that are firm and prevent your spine to curve, and add some gentle stretching to your morning routineDr. Jyotsna Guptahttps://www.facebook.com/gynecologistindelhi/http://gynecologist-delhi.webs.com/

Is Lower Back Pain a Pain in Your Butt?

Dr. Vishwas Virmani, Physiotherapist
How to Treat Lower Back PainRemember those Ooh, aah, ouch! Iodex! ads from the 1980s, when the actors would grimace their way through aches and pains, only to suddenly discover Iodex, and be magically cured?While balms work wonders in ads, seniors dealing with lower back pain need solutions that can help them in the long run. There are a number of different reasons for lower back pain in the elderly, from serious conditions includingbone diseases like Osteoarthritis or systemic diseases like fibromyalgia, to more benig ones like inflammation of the joints.There are a number of treatment options available to seniors struggling with lower back pain. Depending on what's causing the pain, whether it's a disease or just the aging process doctors could suggest invasive and/or non-invasive treatment options.InvasiveFor example, if a growing tumour is what's causing the pain (by pinching certain nerves), doctors might suggest invasive treatments like surgery to remove the growth. They could also suggest 'Interventional Pain Therapy', which includes steroid injections to combat the inflammation that occurs in conditions like facet joint arthritis. Non-invasiveNon-invasive treatments include massage therapy, analgesic medication,and non-opioid drugs called NSAIDS. Low impact exercises like yoga can help stretch, massage, and condition your lower and mid-back muscles.A strong and supple back is essential to your overall health, especially since that's where some of our key core muscles are located.

What a Pain in the (Lower) Back! Symptoms

Dr. Vishwas Virmani, Physiotherapist
Lower Back Pain: Causes and SymptomsAnyone who has ever suffered from lower back pain will know that it is a living nightmare, which can confine you to your bedroom for days. People over 60 are more likely to suffer from lower back pain due to the degeneration of their spinal joints. If you are experiencing any discomfort in your back, you must get yourself checked,to ascertain the reasons behind your back pain. Here are some common causes of back pain:1. Spinal Stenosis: A common cause of back pain in the elderly is spinal stenosis. This is a condition when there is an abnormal narrowing of the spine, and any small injury can trigger severe pain in the back and legs.2. Spondylosis: This affects older women more than it does older men. Spondylosis is a condition when the lumbar vertebrae degenerate or develop small fractures causing lower back pain.3. Facet joint osteoarthritis: This is a kind of arthritis that affects the spine in the later part of life. This degenerative condition might lead to stiffness, discomfort, pain and other problems.Since lower back pain is a very common complaint among older folk, people find it difficult to differentiate between routine discomfort and a serious condition. So, here is a list of symptoms of lower back pain.1. Severe leg pain while walking2. Relief from lower back pain only while sitting down or an increase in pain due to being seated3. Pain fluctuates between mild to severe4. Gradual increase inlower back pain5. Numbness, weakness, tingling sensation and discomfort in back and legs6. Problems in bowel movement7.  Prolonged back pain accompanied by weight lossIf you are experiencing one or more of these symptoms, visit your doctor for a thorough check up. After all, your spine is the backbone of your well-being!

Five Causes of Back Pain Arising Out of Our Lifestyle in the Current Age!

Dr. Vishwas Virmani, Physiotherapist
Ouch! The very term back pain makes you wince in discomfort! Unfortunately, back pain is becoming increasingly common. Not only is it affecting ladies after a certain age, but is surprisingly being suffered by youth and working professionals of all ages.We all want solutions to get rid of this really painful problem. After all, your back is the fundamental support system for the entire body!However, rushing to the solutions, it is utmost crucial to go to the root of the matter and understand why and what we are doing wrong so as to inflict back pain upon us!First – Wrong Posture for prolonged hours is the primary cause for Back Pain!Wrong posture is the most common cause for both, lower back and upper back pain. It is very important to be deliberately conscious of your sitting posture, your reading posture and your standing posture.You back muscles are particularly strained when they are forced to be in a wrong posture for long hours.It is amusing because we are all taught the right postures in schools in our growing up years, and yet, as ’grown ups’, we forget the basics and land ourselves in such painful physical ailments!Second – Inactivity and Lack of Exercise can cause your Back Pain to last forever!On an average, we work for anything between 8 to 12 hours in our offices on a regular basis. As a result, we end up sitting all day long barring a few coffee breaks or lunch wherein we end up stuffing our body with more food and caffeine!We come back late evening, too tired and sometimes lazy enough to go for exercise. And we are of course unable to wake up early in the morning for exercise due to working late till night or late heavy dinner. Thus forms a vicious cycle and we are stuck in it!This lack of exercise on daily basis eventually leads to weakening of the back muscles simply because the back muscles are not being ‘used’. And its obvious, that weak back muscles cannot support the whole body. Only strong muscles can. As a result, one fine day, your back starts to scream in pain!Third – Stressful anxious mind and absence of a peace within you can torment your upper back!Stress is one of the major reasons that causes upper back pain in particular.Increasingly today, people suffer from cervical attacks not only due to constant wrong posture of looking down while reading or working, but also because the mind is not at rest due to work or domestic life stresses of various nature which the body is unable to bear.If you are mentally stressed with negative emotions, undoubtedly, it will impact your body sooner or later. And one of the first body parts to suffer is the upper back region comprising of your beck, shoulders, head and upper spine.Fourth – Lack of rest and adequate hours of sleep can aggravateBack pain multifold!It is fundamental truth that if you body is not well rested resulting from a decent seven to eight hours sleep, you will be vulnerable to multiple health problems. Lack of sleep causes a drop in immunity level of the body and weakens it internally.As a result, when you push your body through the rigours of your daily routine, you back is sure to be inflicted with suffering because it has to support your whole body even though it is not well rested and feeling fresh! On the contrary, your muscles are already tense!Fifth – A protruding stomach with fat accumulated in the centre of your body is a cause of lower back pain!Fat is bad in any case. And fat, when accumulated in the lower abdomen region causing a pot belly to develop, can be even more damaging!This is because you are shifting the centre of gravity of the body towards the front thereby causing further pressure on your spine to keep your body straight! Thus, a big belly primarily caused due to our sedentary lifestyle can cause lower back pain.

Back Pain – What You Should Know

Dr. Vishwas Virmani, Physiotherapist
Ow! My aching back! Most of us have stuttered these words at one time or another. Worldwide back pain affects 4 out of 5 people at some point in life. It is one of the top ten high burden diseases and is largely responsible for decreased quality of life and disability in young adults.  Back Pain SymptomsBack pain can range from a dull nagging ache to sudden debilitating pain. It can affect anyone at any age, but becomes more common as you grow older. People, who are overweight, lead a sedentary lifestyle, under extreme psychological stress and smokers have been found to be at a higher risk for back pain. Some of the common symptoms that occur with back pain include stiffness, trouble flexing your back, difficulty with range of motion, sharp shooting pain, pain radiating down the legs and numbness in the legs or groin.Common CausesBack pain that develops abruptly, often after some activity, is known as acute pain. If your pain lasts for more than three months, it is known as chronic pain. Most causes of acute back pain are related to the muscles and/or ligaments, widely known as strains. Back strains usually result from activities such as heavy lifting, overuse, abrupt movement and poor postures. Chronic pains may be associated with infections, trauma, spinal deformities and problems with the discs, nerves and bones.Understanding the root cause of your back pain is key to preventing it from worsening or recurring. A better resolution of this problem can be achieved when you learn more and start identifying the factors that trigger your pain.10 Tips to Beat Back PainMost episodes of back pain resolve within a few days on its own. Sadly, for some people it can return and can be the most frustrating and bothersome problem to manage. Here are few tips that you can try to minimise your discomfort and prevent the back pain from becoming a long-term issue.Ice the area – Keep ice on the area for the first one or two days. Ice helps slow down inflammation that occurs after an injury. You may switch to heat after two days. Do not place heat or ice directly on your skin and do not keep it for more than 20 minutes at a time.Be active  – Continue your normal activities such as walking and mild exercises, but don’t overdo it. Avoid sitting at a place for more than half an hour, get up and do some mild stretching.Make your workstation ergonomic – Use chairs that have proper back support. Avoid hunching forward often and keep both your feet firmly planted on the floor.Maintain good posture – Avoid stooping or bending over from your waist when lifting heavy objects. Lift with bent knees.Wear footwear with low heels – High heels threaten good posture and put more pressure on the lower spine.De-stress – Anxiety, stress and depression can worsen back pain. Engage in activities that keep you happy.Get enough sleep – Inadequate sleep can aggravate your back pain. Sleep plays a major role in healing your body and mind. Sleep on a mattress that provides good back support. Keep a pillow between your knees if sleeping on your sides. If sleeping on your back, keep a pillow under your knees. These measures help maintain neutral spine position.Quit smoking – Smokers are at a greater risk of developing bone problems that worsen back discomfort.Exercise – Once your back pain has subsided, perform exercises to strengthen your back muscles.Shed some weight – Being overweight can put excess pressure on your spine. Losing weight can help relieve your back pain.There is often no single solution for back pain. You may need to explore and find out what works best for you, which often involves a process of trial and error.It is advised that you consult a qualified doctor if your back pain does not subside within 72 hours. Depending on your type of back pain, your doctor may recommend blood tests and/or imaging studies to identify the root cause of your pain. Depending on your specific condition, treatment options can include oral medications, injections or surgery. You may also choose complementary therapies such as exercises, massage, yoga, biofeedback, acupuncture, physiotherapy and chiropractic treatments that may offer some relief.

Do You Know Your Back Pain?

Dr. David Kirubakaran, Physiotherapist
Back Pain – Prevention & CureBack pain is a serious health hazard, which affects the middle age group. The prevalence has increased in the recent years. It has become hard to control this problem because of the modern, stressful & sedentary lifestyle of our society.  Causes:  The most common reason is wear& tear of Spinal Joints and Discs that leads to swelling called Spondylitis.  Increased amount of calcium deposition in this area leads to bony formation that narrows the canal, through which the spinal nerves exit and there is a tendency for slipping of the disc. This may result in acute back pain which may radiate down the back or side of the thighs and calf muscles. If proper care is not taken, it generally results in numbness, and muscle weakness.Prevention:                              Regular exercise and proper posture has to be maintained, while at work and during commute hours.  It is recommended to avoid sitting or standing for long periods, sleeping in awkward position and using excessively soft mattresses. 7-8 hours of continuous sleep will reduce body’s pain sensitivity.                                                Management:Rest & Pain relieving drugs will be helpful in very mild cases. Skilled physiotherapy consultation is of utmost importance when pain becomes more severe and chronic. Stiff spinal joints, compressed nerves, tight muscle bands and painful trigger points should be manually released in order to maintain joint flexibility and muscle smoothness. Pelvic traction and Interferential Therapy (IFT) will also be helpful to reduce pain. Spinal exercises and posture correction exercises must be followed for permanent results.

Killing Your Back Pain Is Easier Than You Think!

Dr. Vishwas Virmani, Physiotherapist
Perhaps you have an old injury that you ignored and is now bothering you. Or maybe you slept in an odd position and woke up to feeling really uncomfortable and uneasy. Whatever might be the reason for your back pain, this is one problem that is hard to easily get rid of. However, there are relief therapies to reduce your back pain, which, eventually completely cure your back pain. These are:Cold therapyEven with all the high tech medical options available, a simple ice or cold pack application can still be one of the more effective, proven methods to treat a sore back or neck. Ice is typically most effective if it is applied soon after an injury occurs, or after any activity that causes pain or stiffness.Ice can also be very helpful in alleviating postoperative pain and discomfort. While any form of applying cold to the injured area - such as a bag of ice wrapped in a towel or a commercial ice pack - should be helpful, combining massage therapy with ice application is a nice alternative for pain relief.Heat therapyWhile the overall qualities of warmth and heat have long been associated with comfort and relaxation, heat therapy goes a step further and can provide both pain relief and healing benefits for many types of lower back pain.In addition, heat therapy—such as heating pads, heat wraps, hot baths, warm gel packs, etc.—is both inexpensive and easy to do. Some patients find more pain relief with heat (either moist heat or dry heat) and others with ice. You can also try alternating the 2 therapies.Note: If you still do not see any changes in your condition, check with your doctor.