How people experience back and back-related leg pain varies—not only from person to person, but sometimes from episode to episode. Although repeat episodes tend to be similar, they can be quite different and in that case, your treatment may be very different as well.

But even with these differences, the recommended approach to managing back and leg pain tends to be the same—especially for people whose back pain is still in the acute stage (less than six weeks). Even for those whose pain and disability have lasted longer, the approach remains the same; they may just require more help to manage their symptoms.

Be an active partner in your recovery
To reduce your chances of long-term pain and disability, it’s important to take charge of your situation as soon as possible. The best approach to most back and back-related leg pain is “self-management.”

What is “self-management”?
This does NOT mean that you’re left all alone to deal with your symptoms. It does mean:

• educating yourself about your condition.
• following recommendations from your health care provider.
• returning for regular review and if your symptoms do not improve within a reasonable amount of time.
• seeking other opinions if you’re not satisfied with your progress.
• most importantly, taking charge of your own recovery and return to function.

 
A key part of self-management is having realistic expectations. If you’re like most people, your main goal is to stop hurting and return to normal as soon as possible. But as we’ve already said, most back pain occurs from normal wear and tear on the spine—not from some specific injury or other problem. Because of this, it’s important to understand the limitations of treatment. You should be looking for control not cure.

IMPORTANT: Most of the interventions and treatments mentioned on BackCareCanada.ca have the potential to reduce the pain and its impact on your daily life, even if the pain cannot be completely relieved.

Understand the scientific evidence about treatment
If you’ve experienced back and back-related leg pain, chances are you’ve already heard many stories about “the best” treatment—something that worked wonders for a relative or a friend. Or maybe you’ve seen or heard advertisements recommending a new method guaranteed to cure back pain.

But when it comes to high-quality scientific evidence about what works for back pain—and what doesn’t—studies show that no single treatment works all the time for all people. While a treatment may offer of pain relief, it’s unclear whether any treatment, with the possible exception of surgery, actually improves the long-term outcome—since most back and leg pain does eventually get better on its own. Of course, getting rid of the pain is a good thing. It is the overblown claims and unnecessary expense that cause trouble.

Many studies about back pain treatment have been published but the quality of these studies—for example, how they were designed and how the findings were interpreted—varies widely. Some are very good but many are highly biased or misleading. And even when well-designed studies exist, they often show conflicting results about the benefit from one treatment compared to others.

Your own decisions about treatment should focus on what helps you to manage your own symptoms during your body’s natural healing process. Managing a bad back is all about controlling the pain. This includes balancing rest with activity, finding positions or movements that reduce the discomfort and the safe use of pain-relieving medications
(see Non-Surgical Interventions and Treatments).

How to tell whether or not you’re “getting better”
When you have pain from a sprained ankle, the discomfort gets better over time: it hurts a lot on the first, second or third day but the pain gradually subsides until it’s gone for good. But it’s not uncommon for the pain to get worse for a short time if you do something that twists your ankle. You haven’t re-injured the joint or even slowed down the healing process but you have given yourself a new bout of pain.

People with back pain go through a similar recovery process—the pain comes and goes until it’s finally gone for good but there are a lot of things that can make the pain flare up along the way. Here are some things to consider when you have back pain:

• Treatment will not “cure” your symptoms in the same way that antibiotics cure infection or wearing a cast allows a broken bone to mend. While most treatments provide temporary pain relief during the healing process, they have no permanent physical effect.
• Your back is involved in all your body’s movements and constantly exposed to different stresses and tensions with everyday activity. So when you feel the pain getting worse, you may not be able to figure out what you did to produce the symptoms. While this can be frustrating, it’s also very common and should not be a cause of anxiety. In fact, about two thirds of back pain sufferers cannot identify any cause for their pain at all. It just starts to hurt.