This article is an excerpt from Dr. Tuchinsky's book Back Pain: It's All in Your Neck.

This article is part of a six-part series:

1. General Back-saving Tips
2. Strengthening Exercises for Back Pain
3. Back-strengthening Fitness Routine: Part 1
4. Back-strengthening Fitness Routine: Part 2
5. Creative, Everyday Exercises to Strengthen Your Back
6. Treating Back Pain at Home

Perhaps the most practical advice that a health care professional can give is what you can do on your own to ease your back pain. Since most of the healing process goes on outside a doctor's office, it only stands to reason that treating an injured back should lie mostly with the patient at home.

This process speaks to the heart of spinal adjustment theory by allowing the body's inborn healing ability to work for the patient. Once this mechanism can operate freely, the patient must ensure that no further damage comes to the spine.

In this vulnerable stage, there are some important things to keep in mind to help speed the healing process:

• Do not apply heat unless instructed by your doctor.
• Smoking and the use of caffeine may aggravate your problem.
• Do not take hot tub baths without first consulting your doctor.
• Do not walk up or down stairs unless absolutely necessary.
• Do not sleep on your stomach.
• Avoid carrying unbalanced loads.
• Always turn and face toward the object you want to lift.
• Use a bed board under your mattress for firmness.
• When sleeping on your side, keep a pillow between your legs. This will ease lower back pain and sciatica. If lying on your back, put the pillow under your knees.
• If you are fatigued or in pain during activity, rest.
• When moving about, do so in a deliberate and gentle way. Quick movements can put additional strain on your neck or back.
• Try to become active again as soon as the improvement of your symptoms will allow, or if your doctor recommends it. This will help keep your muscles strong.
• Do not lift heavy things.
• Use a long-handled shoehorn to put on your shoes.
• Eat out or have someone else cook. Cooking requires bending, lifting and twisting, all motions that will aggravate an injured back.
• Try eating from a countertop, as it is higher and doesn't require bending over.
• Do not sit in deep, soft chairs. o Let someone else walk the dog, as the jerking motions can cause further pain.
• Try to always maintain a positive outlook.

Applying Heat and Cold
Another home treatment for back pain is heat and cold therapy. The following program can be effective in easing pain while recovering from an injury:

Ice therapy or cryotherapy is an important part of the rehabilitation process because it reduces the swelling of injured tissues, tightens ligaments that hold joints together, and reduces pain. Apply the ice (in a towel) directly to the painful area for 15 minutes every hour. Continue this routine for 6 consecutive hours. Rest for two hours. After completing the initial treatment, repeat the ice therapy every two waking hours.

After the pain has improved by 50%, and only with your doctor's approval, you can try the following routine:

• Apply ice (in a towel) for 15 minutes.
• Apply moist heat (in the form of a moistened towel) for 15 minutes.
• Reapply ice (in a towel) for 15 minutes.
• Apply moist heat for 15 minutes.
• Walk around for about 5 minutes to loosen up the back.
• Rest for an hour and then repeat.

When the pain has improved by 80%, and only with your doctor's approval, you can apply moist heat for 15 minutes, then ice for 15 minutes, then moist heat for 15 minutes. Walk for 10 minutes. Rest for one hour and then repeat.

It is important to note during this home treatment program that initial contact with the ice will be cold (of course), and will be followed by a tingling sensation, then a burning sensation, and then finally numbness. These are normal reactions. However, do not leave the ice on for a period longer than 15 minutes, regardless of numbness, as this can cause frostbite.

Is Bed Rest Best?
For years, those with back pain were instructed to get as much bed rest as possible, sometimes up to weeks at a time. However, this has recently been shown to weaken muscle strength and prolong recovery.

A vicious cycle results where the weakening muscle leads to more pain, which makes the patient want to rest more, and so on. It is now recommended that for cases of acute back pain, the patient should resume normal activity as soon as their recovery allows. The best alternative seems to be a compromise between immobility and moderate activity. If you are recovering from back pain, try to increase your movements gradually and steadily.

Extended bed rest has been shown to discourage a return to work. The longer an employee remains out of work, the less likely he or she will be to return. After three months of bed rest, the chances of returning to work ever again drop dramatically. Most of health care costs go toward the small percentage of people who become disabled.

You don't need a doctor at all times to help relieve your back pain. Taking care of your back on your own—at home—can make a significant impact on the overall health of your spine.