Most low back pain will improve with the following treatment:

• Apply ice for the first 2 or 3 days after you hurt your back, then switch to heat. Use an ice pack for 5 to 15 minutes every 2 or 3 hours. After a couple of days, use a heating pad or take a hot shower for 15 to 20 minutes every 2 or 3 hours.
• Take over-the-counter pain medicine, such as acetaminophen or an anti-inflammatory drug such as aspirin or ibuprofen. These medicines usually work best if you take them on a regular schedule instead of waiting until the pain is severe.
• For the first day or two, rest in a comfortable position . Try lying on your side with a pillow between your knees. Or lie on your back on the floor with a pillow under your knees.
• As soon as possible, get back to your normal activities. Staying in bed for more than 1 or 2 days can weaken your muscles and make the problem worse.

Walking is the simplest and maybe the best exercise for the lower back. It gets your blood moving and helps your muscles stay strong. Start with easy walks of 5 to 10 minutes a day, and gradually increase your time. Walking in water up to your waist or chest is also good exercise.

Some people get relief from pain by using treatments such as massage, chiropractic, or acupuncture. Certain treatments work for some people but not for others. You may need to try different things to see which work best for you.

Only a few people with low back pain need surgery. Surgery may help if you have a herniated disc or back pain along with symptoms of nerve damage, such as numbness in your legs. Even in these cases, most people will improve without surgery. Having surgery does not guarantee that all your pain will go away. Before you have surgery, it is a good idea to get a second opinion.