This lower back pain can block us for days or even weeks. Medication or manual therapy, solutions exist, depending on their duration and intensity. Update on the different treatments for lumbago or sciatica.
While more than one in two people experiences at least one episode of low back pain in the year, and one in ten have sciatica pain, we have learned from studies carried out in recent years (source 1) that paracetamol was not more effective than a placebo. So what do we do?
What to do when you are stuck in pain?
Take a painkiller
“Be careful not to misinterpret these studies!” Warns Dr. Georges de Korvin. The paracetamol doesn’t solve everything, but my experience shows that pain relief is real. “
You can repeat the catches every four hours (maximum 4 g / day) or, if tolerated, takeibuprofen, up to three doses of 400 mg per day, every six hours, alone or alternately.
In the case of sciatica, they will not be enough. The codeine paracetamol (20 mg of codeine, without prescription) relieves more and the doctor may prescribe a stronger analgesic (paracetamol codeine 30 mg).
Also read: Back pain: which painkiller solution to choose?
Adopt the right position
We often feel better standing during the crisis. In a seated position, place a cushion in the small of the back.
“Conversely, we must avoid all forward positions and movements that cause the back to roll up,” recalls Xavier Dufour, physiotherapist.
Heat has been proven to relieve low back pain. We use a hot water bottle or heating patches.
The pain lasts several days: what solutions?
“It is necessary to perform movements in a direction opposite to the painful position, most often in extension”, specifies Xavier Dufour, who. Repeat 10 stretches, three to five times a day.
- Standing, hands on the hips, stretch the spine up and back by pushing the pelvis forward, on the exhale, smoothly.
- Face down, arms bent, lean on the wrists, near the shoulders, and stretch out the arms. Hold for 10 seconds and go back down. In the case of sciatica, bend the leg on the painful side.
Opt for manual therapy
A chiropractor (40 to 80 € per session, supported by some mutual funds) or a physiotherapist (reimbursed at 60%, on prescription) works on muscle tension to relieve pressure on the discs.
“You should feel relief from the first session. If this does not change anything, no need to repeat the sessions recommends Dr. de Korvin. On the other hand, sciatica is a contraindication to “cracking” manipulations, because they can fragment an already weakened disc and aggravate the hernia. “
Wearing a lumbar belt
It forces you to take an upright position, which reduces the pressure on the discs. to be used as long as it is painful, but without exceeding two months so as not to risk atrophying the muscles. In pharmacies (50 to 70 €).
We have back pain regularly: how to relieve this chronic pain?
Muscle his back
“It is the best treatment for chronic pain, which has lasted for more than three months”says Dr. de Korvin.
This rehabilitation can be done in physical medicine departments, back schools, or physiotherapy, at the rate of three sessions per week for one month (reimbursed at 75%).
Using infiltrations in case of sciatica
Thiscorticosteroid injections reduceinflammation around the sciatic nerve, and are effective in 65% of cases: we feel the improvement the next day. A second infiltration can be considered, or even a third. Beyond that, the benefit/risk (infection) ratio decreases.
“Studies show that they are all the more effective when they are performed under fluoroscopic guidance,” says the doctor. From 150 to 250 €, partially reimbursed.
Try specific analgesics
Pregabalin (Lyrica) and gabapentin (Neurontin) act on the nerve fiber itself: on prescription, they can be useful for neurological pain associated with sciatica.
No manipulations without medical advice
Sciatica, like lumbago, is often caused by the onset of a herniated disc: a small piece of the intervertebral disc protrudes or moves, and can compress a nerve. “It is therefore important to always establish a medical diagnosis, in particular before considering manual manipulations which could aggravate the hernia”, recalls Dr. Georges de Korvin.