• Return to your normal daily activities and work as soon as you can, although you may need to modify or limit some work tasks.
• Avoid bed rest. Bed rest is not an effective treatment for back pain and may cause you to heal more slowly.
• Apply an ice or cold pack to the injured area for the first 48 to 72 hours. Apply cold packs or ice for 15 to 20 minutes, 3 to 4 times a day or up to once an hour. Cold decreases swelling and pain. Keep a towel between your skin and the ice to prevent frostbite. Do not fall asleep with the ice on your skin.
• Change position every 30 minutes. Gently massage or rub the area to relieve pain and encourage blood flow. Do not massage the injured area if it causes pain.
• For the first 48 hours after an injury, avoid things that might increase swelling, such as hot showers, hot tubs, hot packs, or alcoholic beverages.
• After 48 to 72 hours, if swelling is gone, apply heat. Use a warm pack or heating pad set on low. Some experts recommend switching back and forth between heat and cold treatments. You can also begin gentle exercise with the aid of moist heat to help restore and maintain flexibility.
• Avoid sitting up in bed, sitting on soft couches, and twisting or sitting in other positions that make your symptoms worse.
• Try one of the following sleep positions if you have trouble sleeping at night:
  • Lie on your back with your knees bent and supported by large pillows, or lie on the floor with your legs on the seat of a sofa or chair.
  • Lie on your side with your knees and hips bent and a pillow between your legs.
  • Lie on your stomach if it does not increase your pain.
• Begin moderate aerobic exercise. Take short walks (3 to 5 minutes every 3 hours) on level surfaces as soon as you can to help keep your muscles strong. Avoid hills and stairs. Walk only distances that you can manage without pain, especially pain in your legs. Add to your exercise program every week to continue your progress.
• Do pelvic tilt exercises to gently move the spine and stretch the lower back. Lie on your back with your knees bent and feet flat on the floor. Slowly tighten your stomach muscles and press your lower back against the floor. Hold the position for 10 seconds. Do not hold your breath. Slowly relax.

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