Learn how to help someone who has just thrown out his or her back and is suffering from lower back pain and/or upper back pain.

Witnessing someone hurt their back can be a scary experience. That moment of watching someone go from full mobility to practical paralysis can leave you with a lot of questions: Should you be rush  them to the ER? Should you apply ice or heat? What position is best for achieving back pain relief? How long will it take to recover? These are all common concerns.

Back Pain Relief: When Is Emergency Care Warranted?
In most cases, there’s no need to rush to the emergency room to achieve back pain relief. “The person doesn’t need emergency care unless they can’t feel their legs or have severe numbness going down their legs,” says Cynthia Gormezano, MPT, owner of Cynergy Physical Therapy in New York City. Another case in which a hospital visit is warranted is if there is stinging nerve pain running down the leg. People with that type pain may need magnetic resonance imaging (MRI) to rule out serious injury. In severe cases, a herniated disc that has bulged out of place may be pressing on the spinal cord, requiring emergency surgery. However, says Gormezano, “that is very rare.”

Back Pain Relief: First Steps
Everyone’s pain threshold is different, and some people may feel the need to visit the hospital to get prescription pain medications. But the majority of people can be treated at home with a generous dose of ice and over-the-counter anti-inflammatory medications, such as naproxen (Aleve) or ibuprofen (Advil, Motrin). The best thing to do immediately after someone throws out their back is to have them lie down on a firm surface and apply ice to the sore area. “Ice is absolutely key,” says Gormezano.

For those who are able to move around without further injuring themselves, it’s okay to do so. But “don’t force it,” says Gormezano, noting that pain can get worse if it is not addressed properly in the initial days after injury. After a couple days of rest and ice, the person should start to feel better. If after three to five days there is still no back pain relief, it’s a good idea to take the person to the doctor.

"When I hurt my back a few years ago, I tried to get back up and moved too fast, too early, which left me with lingering soreness for over six months," recalls Christine Primavera, a Massachusetts resident who recently re-injured her back while playing golf. "This time, I made sure to rest and ice the injury until I was really ready to return to normal activity. And, after the fifth day, I had full mobility again."

Back Pain Relief: Initial Exercises
Assuming the person is on the mend, it’s appropriate to begin applying heat instead of ice and to help them start performing some slow pelvic-tilt exercises. Before beginning any exercise regimen, however, Gormezano recommends that the person perform a self-assessment. “First, have them stand up and evaluate their pain." she says. "They should ask themselves, ‘Does bending forward make me feel better, or does extending backward feel better?’ If the extension feels better, the person should sit down and lean backward for sets of six repetitions. If moving forward brings back pain relief, the person should lie on his back and bring his knees to the chest. This is a great way to start stretching the back.”

In addition to performing these exercises, those recovering from a recent injury can speed their path to recovery by sleeping on a firm surface and using "log rolling" when getting out of bed. Log rolling means moving the body as one unit opposed to bending or twisting. Twisting motions in general should be avoided, and heavy lifting of any kind is discouraged.