When persistent low back pain affects everyday activities, relieving symptoms is a priority. People who also have rheumatoid arthritis will want to try treatments that do not exacerbate RA joint pain or interfere with their prescription medications.
Most first-line treatments for relieving low back pain can be done at home. Many of these strategies are also recommended for rheumatoid arthritis, so they may help reduce RA joint inflammation and fatigue in addition to low back pain.
Certain treatments offer immediate, short-term relief of low back pain while others address the underlying causes and may provide longer-term relief. The goals are to be able to work, participate in hobbies, and rest comfortably.
Immediate Relief for Low Back Pain with RA
There are several ways to get fast, temporary relief for an aching low back. These treatments are considered generally safe for people with rheumatoid arthritis.
Anyone with RA is accustomed to a little joint pain, particularly in the morning as stiff joints loosen up. However, when low back pain is moderate to severe, the muscles and joints of the spine probably need rest. When pain is extreme, 1 to 2 days of rest may be necessary.
Warm and cold therapy
Applying a warming pad for 10 to 20 minutes may loosen the muscles of the back and improve the range of motion. Alternatively, taking a warm shower or bath may ease stiffness in the low back as well as joints affected by RA.
If low back pain occurs after activity, such as prolonged standing or exercise, try icing the low back for 10 to 20 minutes to decrease pain and swelling.
Like warm and cold therapy, topical medications can provide temporary relief from low back pain. There are several different kinds of pain-relieving creams, balms, gels, and patches that can be applied to the skin over the lower back. These products may contain:
- Counterirritants, which work by creating temporary hot or cold sensations that distract the brain and interrupt pain signals
- Salicylates, which deliver a small dose of anti-inflammatory medication that is chemically similar to aspirin
- Capsaicin, which works as a counterirritant and may also help interrupt pain signals.
- Anesthetics, such as lidocaine, which numb the area treated
- Cannabidiol (CBD) infused creams, balms, and gels, which may reduce inflammatory and neuropathic pain
Over-the-counter topical medications are generally considered safer than oral medications. However, topical medications are usually absorbed through the skin and enter the bloodstream, so side effects and interactions with other medications are possible. A pharmacist or physician can help address concerns.
Do not use topicals and hot or cold therapy at the same time:
- Combining hot and cold therapy and topical medications can lead to skin damage
- Hot and cold therapy can affect the absorption of topical medications
Longer-Term Relief for Low Back Pain with RA
Changing one or more lifestyle habits can go a long way toward easing low back pain. Making a few simple changes may relieve low back pain, improve function, and have a positive effect on RA symptoms as well.
Actively manage RA disease activity
Low back pain is less likely to develop when rheumatoid arthritis is well managed. Patients are advised to take medications as scheduled and work with physicians to increase dosage or change medications that are not working well.
Lose excess weight
Carrying extra weight increases the likelihood of back pain developing. This is true for everyone, both with2 and without rheumatoid arthritis. Losing excess weight will take strain off the spine and may slow down or even prevent future back problems.
Dietary changes are typically necessary to lose excess weight. A high-fiber, plant-based diet that emphasizes eating fruits and vegetables may help decrease weight as well as inflammation.3,4,5,6 Exercise can also help manage weight.
Avoid activities that put unwanted stress on the lower spine
It's best to avoid movements that aggravate the joints in the low back. Examples of movements that may result in pain include, but are not limited to:
- Heavy lifting, including carrying heavy bags or backpacks
- Deep bending at the waist
- Significant twisting of the torso
If these movements are done, they should be done slowly and with caution.
Taking steps to improve posture can improve spinal alignment and reduce low back pain. Improved posture can also reduce the risk of vertebral fractures, which can cause back pain or make it worse.10
A physician or physical therapist can provide exercises and tips for improving posture.
Strengthen core muscles
Physical therapy and regular exercise may reduce low back pain and prevent it from getting worse. Stretching and strengthening the muscles in the low back can ease pressure on the spine’s joints and intervertebral discs. As the core muscles get stronger and the spine is better supported, symptoms may lessen or go away completely.
These suggested treatments can be used alone or in combination to help decrease pain and increase low back function.
Getting a Diagnosis for Back Pain
The best way to know for sure what is causing low back pain is to see a medical doctor for an accurate diagnosis and treatment recommendations. Consult a physician if low back pain persists for more than a few weeks or if the pain is severe. While rare, back pain may be an early indicator of a more serious medical condition.
Diagnostic evaluations can be done by primary care physicians as well as orthopedists, physiatrists, osteopaths, and rheumatologists.
Depending on the cause and severity of low back pain, a doctor may suggest nonsurgical treatments, such as physical therapy, pain-relieving medications, and/or activity modification. Sometimes, minimally invasive procedures such as epidural steroid injections may be advised. Surgery is rarely recommended unless other treatment options have been exhausted.
Read more about Causes of Lower Back Pain on Spine-health.com