Acute Low Back Pain

Acute low back pain can be caused by many things but the most common cause is muscle strain. Pain sometimes starts immediately after a specific event (like twisting, bending, or lifting something very heavy) or it may not start until several hours later. In some cases pain can occur for no obvious reason. Sometimes the symptoms become a vicious cycle of muscle spasm causing pain, which results in more muscle spasm.

Other causes of acute low back pain

  • A ruptured disc. The discs are like cushions between the bones in the spine. When they rupture, they can cause pressure on nerves coming from the spinal column and cause pain and weakness.
  • Osteoporosis
  • Spondylosis (hardening and stiffening of the spinal column)
  • Nerve dysfunction
  • Infections
  • An injury due to a fall or a blow

In most cases, low back pain goes away within a few days and nearly all cases of low back pain get better within 4 weeks. Risk for low back pain goes up with sedentary occupations (such as desk jobs), obesity, poor posture and muscle tone, poor general physical fitness, infrequent strenuous physical activity such as occasional sports participation ("weekend warriors") or yard work, use of poor lifting techniques, and wearing high heeled shoes.

Symptoms of acute low back pain may include:

  • Pain
  • Stiffness
  • Numbness
  • Weakness
  • Problems with coordination

What your urgent care doctor can do for low back pain

  • Ask about your symptoms and what may have caused them
  • Examine you to look for signs of nerve injury (weakness, numbness, etc)
  • Order additional tests if the pain continues beyond 1 month; is accompanied by numbness or weakness in the leg or groin; or if it is caused by a serious injury. These may include laboratory blood tests or x-rays.
  • Recommend a CT or MRI scan if symptoms have lasted more than a month or if certain specific symptoms occur
  • Prescribe any of several medications to relieve symptoms.

What you can do for low back pain

  • For the first 48 hours, apply ice for 10-15 minutes at a time every 1-2 hours
  • Rest - avoid activities that make your pain worse and avoid prolonged sitting, bending, heavy lifting, of twisting
  • Use anti-inflammatory medications such as ibuprofen or naproxen
  • Use any prescribed medications for muscle spasms
  • Bed rest is not usually necessary although your doctor may recommend it for the first 24 hours if you have severe pain
  • After the first 48 hours use a moist heating pad, hot compresses, or take a warm bath or shower several times daily
  • Continue your daily schedule as much as possible but avoid strenuous activities for several weeks
  • Physical therapy and stress reduction may help
  • In general, staying active is better for back disorders than prolonged bed rest.
  • Prevention and avoiding the recurrence of low back pain can best be achieved with back strengthening exercises, sleeping on a firm mattress, good posture when sitting and standing, wearing proper-fitting shoes, using special back supports, and knowing and using proper body mechanics. Weight reduction is important if you are obese.

What you can expect

  • Proper treatment results in complete recovery in most cases. Recovery is gradual and recurrence is common.
  • Complications include chronic low back pain. Chronic back pain can be difficult to treat.

When to contact an urgent care doctor

Visit an urgent care doctor or contact your primary care doctor if back pain is not better after 3-4 days of self-treatment, if you have severe or recurrent back pain, new unexplained symptoms, or treatment side effects. If you are still having pain after 4 week, you may want to discuss other treatment options with your doctor. These may include electrical nerve stimulation, acupuncture, or chiropractic. Surgery is very seldom the best treatment choice but there are some cases in which it is recommended.

Seek immediate medical assistance if you are numb in the groin, are running a fever, have difficulty going to the bathroom, or lose bowel or bladder control.

Aching back?

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