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following non surgical options not involving pain relievers can be tried;
1) Back care in the activities of daily living, which is an integral component of the treatment of back problems. Back education is one of the most important thing which teaches the basic body mechanics, like correct posture for standing, standing at a desk or drawing board, sitting, brushing teeth, washing the face, pushing and pulling a weight, lifting a weight, getting in and out of bed, sleeping, getting into and sitting in a car. The training for these routine activity helps in preventing the spasm of the muscles. One needs to consult an occupational therapist or physical therapist which can educate about the proper and improper behaviors when back is painful in case one has to sit, bend forward, lie down, walk, cough, or sneeze. Following more need to be done:
a) Avoid activities which increases the pain.
b) Rest intermittently
c) Avoid bending at 90 degrees
d) Pushing and pulling should be avoided till pain subsides
f) Avoid prolonged sitting and standing
g) Avoid sitting or sleeping on floor
2) Chiropractor manipulation
3) Local analgesic gels or sprays / ointment
4) Hot fomentation
5) Deep Electrotherapy (done at physical therapy centers); like trans cutaneous electrical nerve stimulation,short wave diathermy, electrical stimulation, phonophoresis, iontophoresis, relaxation, and biofeedback.
6) Good supervised physiotherapy in the swimming pool. Spa treatment/mild massage may also help.
7) Lumbosacral corset or support or brace
8) If obese or over weight, reduce weight for long term benefit.
9) Epidural steroid shots
11) Lumbar traction
12) Tilt table; it gives traction due to the posture.
Surgery is usually last resort, when the above conservative measures fail.
Please feel free for your follow up questions.
You cannot go to your work till you pain comes down to the zero level. And even after that for 6 weeks, you should not lift weight more than 10 lbs. Physical therapy is the mainstay of the treatment and I did not mention that in my last reply because you said that you are already doing it and it aggravates your pain. The basic principles of the physical therapy are;
1) Be very gentle with the body.
2) Do not do those exercises which are painful. You would need to guide your therapist about it.
3) Ask the physical therapist to not get over enthusiastic/aggressive with the exercise regime. Go slow is the watch word.
4) Be patient.
This can take about 6 weeks to get better or to get complete relief. This is not a life long problem and once you get better, everything including the sporting activities are allowed, once your back muscles are again strengthened.
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