Acute backache is predominantly a musculo-skeletal pain condition leading to intense pain around spine. Patients often present with muscle spasms and limited movements with or without evidence of nerve root compression.
Medications:
- Tab. Dolokind MR (Aceclofenac 100 mg, Paracetamol 325 mg, Chlorzoxazone 250 mg) 1 tablet twice a day for 5 days AND
- Tab. Pantakind 40 (Pantoprazole 40 mg) 1 tablet a day for 7 days for gastric protection.
- Gel Powergesic 2X (Diclofenac 2.32%, Methyl Salicylate 10%, Menthol 5% w/w) to be applied over painful area thrice a day for 7 days.
- If patient is not diabetic or hypertensive – 7 days course of steroid – Tab. Zempred 4 (Methylprednisolone 4 mg)
Day 1 – 2 tablets before breakfast, 1 tablet each after lunch, dinner and 2 tablets at bedtime (total dose 24 mg per day).
Day 2 – 1 tablet before breakfast, 1 tablet each after lunch and dinner, 2 tablets at bedtime (total dose 20 mg per day).
Day 3 – 1 tablet before breakfast, 1 tablet each after lunch, dinner and at bedtime (total dose 16 mg per day).
Day 4 – 1 tablet before breakfast, 1 tablet each after lunch and at bedtime (total dose 12 mg per day).
Day 5 – 1 tablet before breakfast and at bedtime (total dose 8 mg per day).
Day 6 – 1 tablet before breakfast (total dose 4 mg per day).
General advice:
- Bed rest on a firm surface.
- Initially cold compression 15 minutes every 2 hours.
- Avoid standing or sitting for long time.
- Avoid lifting heavy objects and massage.
- Gradual mobilisation after two days and advice gentle physiotherapy.
- Waist belts may be useful for a short period.
- Consider application of kinesiology tape to reduce local strain.
Referral:
Consider referral to physiotherapy once acute phase is resolved. For longstanding cases consider referral to orthopaedic surgeon.