Guidelines for successful recovery from low back pain In addition to stretching, strengthening and aerobic exercises, there are several basic guidelines that can help you in your healing and rehabilitation process. These guidelines include: Manage anxiety about low back pain Controlling anxiety and fear of re-injury and low back pain is very important to regain normal muscle function. The basis for these psychological reactions to low back pain lies in the central nervous system, which responds to pain by instructing the muscles near the affected part to protect against further injury. Only appropriate physical training that specifically tells the muscles to improve their function can overcome this neurological barrier to normal muscle function. Eat properly to help the back heal The healing process can be aided with appropriate nutrition, which includes adequate calorie intake in a balanced manner. If all calories consumed are in the form of sugars (such as breads, pasta, and sweets), any calories not immediately needed for energy are converted into fat. You don't need extra weight while you are in the healing process. Your diet should include adequate protein as a source of the building blocks of soft tissue healing. Additionally, fresh fruit and vegetables supply the vitamins and trace elements necessary for effective healing. A vitamin supplement may also be helpful. Get adequate sleep to support the healing process One of the best ways to encourage sleep is to induce physical weariness through active exercise. Chronic inactivity does not create a need for the deep sleep that is so helpful for physical and emotional healing. Clearly, stimulants such as caffeine or nicotine should be avoided at bedtime. Smoking should also be avoided because it diminishes the available blood supply and makes the nervous system more sensitive. Control medication use for back pain While medications are often important for low back pain relief, one should also be careful about the use of medications. For example, use of narcotic medications and muscle relaxants over time may cause depression and should be used as little as possible. Also, while anti-inflammatory medications may provide low back pain relief, there is no evidence that they do anything to speed the process of healing. The use of heat therapy or cold therapy, or liniment or massage therapy, as a mechanism for pain control is a very safe and positive alternative for low back pain management. Exercise properly for back fitness Exercising in a controlled, gradual, and progressive manner is the only way we can tell our body to heal. Injections and medications can provide low back pain relief but cannot stimulate the healing process. If a pain problem has persisted for many weeks, the body is demonstrating that there are barriers to the healing process that need to be eliminated. The natural stimulus for the healing process is active exercise. Active exercise means we use our nervous system to tell the muscles what to do, and includes dedication to an appropriate, comprehensive exercise and rehabilitation program. Work with a professional for low back pain Finally, an important guideline is to seek the assistance of an appropriately trained and licensed health professional for back rehabilitation and exercise. And it’s always important to see a physician if the lower back pain lasts for more than a few weeks or a month or if there are any symptoms that cause concern, as the continued pain and/or symptoms may signify a serious medical condition. Ultimately, participating in developing and maintaining an active rehabilitation and exercise program for low back pain should help you heal faster and have fewer recurrences of back pain. By: Vert Mooney, MD June 25, 2001