How it works: When back muscles hurt, the pain is usually caused by inflamed tissue. Cold reduces the swelling and discomfort, says Jason Highsmith, a neurosurgeon in Charleston, South Carolina. As soon as you feel pain, apply cold several times a day, 10 minutes at a time, for about three days. A bag of frozen peas works, or try a cold pack, like an Ace Reusable Cold Compress ($10 at drugstores).
Good to know: Heat can help after the initial three days. (Using it too soon can worsen inflammation.) Apply a heating pad several times daily, 15 minutes at a time, for three days, says Jeffrey Katz, a professor of medicine at Brigham and Women’s Hospital, in Boston.
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Over-the-Counter Pain Relievers
Try them when: Cold or heat isn’t enough.
How they work: Both types—nonsteroidal anti-inflammatory drugs, or NSAIDs (such as Advil), and acetaminophen (Tylenol)—inhibit chemical pathways in the body that can produce pain. Since these medications are “purely for symptom relief,” says Katz, choose whichever you’ve responded to best in the past.
Good to know: Take NSAIDs with food, as they can cause nausea. And limit yourself to eight extra-strength acetaminophen tablets a day. (In rare cases, more can cause liver problems.)
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Try them when: You want an alternative to pills.
How they work: When applied to the skin, these creams cause nerve endings to feel either heat or cold, which dulls pain. Ingredients to look for: cooling menthol; salicylate, the compound in aspirin; or capsaicin, a heat-stimulating substance found in hot peppers (try Capzasin HP, $14 at drugstores).
Good to know: Some creams can irritate the skin or cause redness, says Katz. Wash your hands after applying, and—common sense—don’t get them in your eyes.
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Try it when: Your back feels mildly stiff.
How it works: “Activities like walking, biking, and water exercise improve almost all muscle-related problems in the body,” says Katz. Exercise also stimulates feel-good endorphins, which may help reduce pain.
Good to know: To stave off stiffness most effectively, commit to 30 minutes of low-impact activity three times a week. (When biking, adjust the seat to hip height for the most comfortable ride.) And consider strength training. One 2010 study showed that people who lifted weights four times a week experienced a 42 percent decrease in back pain.
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A New Mattress
Try it when: You ache every single morning
How it works: After eight or nine years, a mattress can start to provide less support, which may lead to back pain. “People who suffer from constant backaches often find relief by getting a new mattress,” says Todd Sinett, a New York City chiropractor and a coauthor of The Truth About Back Pain ($15, amazon.com).
Good to know: Contrary to popular belief, a firmer mattress isn’t necessarily better. Research shows that medium tension is best. Beware of those that are advertised as “orthopedic” or “doctor approved.” There is no regulation for these claims. Chances are you’ll just pay a heftier price than you would for a regular mattress.
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Physical Therapy or Chiropractic Treatment
Try it when: No matter what else you do, your backaches persist. “A professional can provide relief from chronically inflamed muscles that home remedies can’t,” says Sinett.
How it works: A misaligned spine can cause muscle tension (read: pain). Both physical therapy and chiropractic treatment improve spinal alignment. Physical therapists strategically stretch and strengthen the muscles that help hold the spine in place. Chiropractors manipulate the spine to relieve areas of tension on the muscles. Consult your primary-care doctor for a referral.
Good to know: “You should experience relief within six weeks,” says Sinett. If you don’t, you may need an MRI, which can determine whether the pain stems from something more serious, such as a herniated disk.