If you have sprained your lower back muscle and you have been administered painkillers by your doctor, this is usually enough to treat the chronic back pain. However, since this is not the case, the evidence points to the fact that you are continuing to place stress on the affected region and definitely not resting it.
It is helpful to understand some of the physics of the spine and the muscles of the back to be able to treat it. You have to think of the human body as a kind of a lever with the focus – or center of the lever – being the spine. This obviously does not make for a very even lever, and one would end up putting a lot of effort at the shorter end of the lever, to elicit a response on the other end. However, since it is the other parts of the body that does most of the lifting and other kind of work, the back muscles have to make a counter balancing force in a very small area, otherwise humans would not be able to do any work or move properly. This is where the problems with lumbago and back pain arise. Any kind of excessive effort or incorrect maneuvering, while doing some work will cause the muscle to be excessively pulled – perhaps even traumatically. Therefore, one of the most important things that you can do to treat a backache and muscular sprain is to do nothing at all. This means that you must rest completely. The ideal position is one that is a sleeping position with possible support to the back if required for comfort. Then, you need to be absolutely still for a long period of time, sometimes a whole day or more before things can return to normal.
Hot and cold compress is required when you have a backache. A cold compress is used when there is an inflammation and you want to reduce the inflammation. A hot compress is used to soothe and stimulate the circulation in an affected area; which of the compresses to use depends on how long you have had the problem. If the injury is recent then you should use a cold compress and once the pain dies down in a few days, switch to a hot compress or a hot water bag for the final thermal therapy. If it has been some time since the pain first started then you can move straight away to the hot compress or hot water bag.