Chronic pain
Initial management of pain due to osteoarthritis

Sonia (48 years old)

Sonia, a 48-year-old civil servant, comes to your clinic with acute severe low back pain that started while lifting heavy luggage a few days ago. She took painkillers, 3x paracetamol 1 g in the last 48 hours, which only temporarily alleviated her symptoms.

In her medical records, the following is noted:

  • Similar episodes of acute low back pain (N=2), but less severe and resolving more rapidly
  • Sedentary lifestyle, no physical activity
  • Intense smoking (20 cigarettes/day)
  • BMI: 29
  • No chronic disease or other conditions

In addition to quitting smoking and reducing weight, she asks which non-pharmacologic options can be considered to reduce the pain.

What would you advise to this patient?