Acute Back Pain

If you have low back pain, you’re not alone. Acute low back pain (pain that lasts 8 weeks or less) is very common. In fact, it’s the second most common reason that people visit their doctor.

More than 80% of people will have an episode of acute low back pain sometime in their lives. Over the years, scientific evidence has disproved many back pain myths, revealing the basic prevention and treatment options that work best.

Symptoms depend on the injury and will be different in each case. In general, most people feel:

• Tightness, or reduced range of motion in the lower back
• A burning sensation
• Sharp, intense pain when moving

See your doctor immediately or go to the nearest emergency room if you have any of these symptoms:

• Difficulty urinating or controlling urine
• Blood in your urine
• Loss of bowel control

Make an appointment to see your doctor if you develop any of these symptoms:

• Sudden, severe pain
• Severe back pain that gets worse over several weeks instead of getting better
• Back pain that lasts longer than 8 weeks or returns regularly
• Numbness or weakness in your legs
• Fever

The exact cause of low back pain is often hard to pinpoint. Most acute (sharp or intense) low back pain is probably caused by muscle strain — usually from doing an activity you’re not used to (such as yard work, moving furniture, or heavy lifting). Or, you may have sprained the ligaments between your vertebrae (the bones in your back) or in the sacroiliac (SI) joint in the lower back. Less often, one of the discs that normally cushion your vertebrae can push out and press on a nerve.

The good news is that acute back pain is rarely caused by damage to your spine or by any other serious medical condition. In fact, in most cases you can recover quickly on your own — at least to the point where you can do normal daily activities.

Your doctor can rule out most serious conditions from a medical history and physical exam alone. In most cases, you DON’T need special lab tests, x-rays, or an MRI — in fact, these tests usually don’t help. If your doctor does suspect a serious condition, he or she will refer you to an appropriate medical specialist.

Based on the information gathered in your medical history and physical exam, your doctor may provide a range of treatments. The most common treatments include:

• Education and activity recommendations. Your doctor will talk with you about avoiding bed rest, staying active, and practicing good body mechanics.
• Medications for pain relief. Your doctor may recommend over-the-counter or prescription-strength anti-inflammatories (such as ibuprofen or naproxen) or acetaminophen. For more severe cases, you might need to take a short course of muscle relaxers to reduce muscle tension and increase ability to move. Acute back pain rarely requires treatment with steroids or narcotics.
• Referral to a physical therapist. A physical therapist can create and supervise an individual exercise program for increasing your flexibility and strength. Earlier treatment tends to produce better results than waiting. (If your insurance doesn’t cover physical therapy, ask your doctor for exercise recommendations.)

Not all back pain episodes require a doctor’s visit. You can often manage your pain on your own and return to normal activities in a short time. Try these suggestions:

• Keep moving. It’s natural to want to avoid using your back when it hurts. However, for most types of back pain, inactivity — especially bed rest — can slow the healing process and make your muscles weaker, tighter, and more painful. Although you do want to avoid activities that make your pain worse, stay as active as possible.
• Find a comfortable position. When you do rest, you may have to experiment with positions to relieve your pain. Try lying on your back with a pillow under your thighs or on your side with your knees bent and a pillow between your legs.
• Apply heat or cold. Cold (an ice pack or bag of frozen vegetables) can lessen your pain, while heat (a hot water bottle, heating pad, or warm bath) can loosen tight muscles. Apply ice or heat for 15 minutes at a time each hour, alternating the two for best results.
• Try simple pain medicine. Control your pain with the following over-the-counter medicines:
• Anti-inflammatories, such as ibuprofen (generic, Advil, Nuprin, or Motrin) or naproxen (Aleve), relieve pain and also help reduce inflammation.
• Acetaminophen (generic, Tylenol, Excedrin) also help to relieve pain.

Pain medicine should control the pain enough that you can be active. If you take medicine for any other medical condition (such as high blood pressure, diabetes, or arthritis), check with your doctor before taking any over-the-counter pain reliever. Also, be sure to follow the directions on the packaging.

There are certain things you can do to lower your chances of having problems with your back. Here are some suggestions:

• Practice good body mechanics. The term “body mechanics” refers to how you move and hold your body. Building good habits is one of the most important things you can do to protect yourself from painful back episodes. See the table for some DOs and DON’Ts of good body mechanics.
• Get regular exercise. Regular activity keeps your body strong and flexible to help support your back. Establish and maintain a regular exercise program that includes aerobic training (such as walking, swimming, or cycling) as well as stomach and back strengthening.
• Manage your weight. Extra pounds put extra stress on your back, hips, knees and ankles. To lose weight, eat more fruits, vegetables, and low-fat foods. Keep portions small, avoid junk food, and exercise regularly!
• Avoid activities that require heavy lifting, trunk twisting, or bodily vibration. These activities can place lots of stress and strain on your back. Avoid them when possible — and always use proper body mechanics.
• Reduce stress. Stress has also been shown to affect low back pain. Stress can cause muscular tension and sometimes spasm. Look at ways to reduce or manage the stress in your life.

To learn more about acute low back pain, please visit:

• North American Spine Society
• MedlinePlus
• American Academy of Orthopedic Surgeons