Frequently Asked Questions

Acute Low Back Pain

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What is acute low back pain?

Acute low back pain is discomfort in your lower back area that lasts for less than 12 weeks. The word acute is used to describe pain that starts suddenly, worsens quickly, and lasts for a short time.

What causes acute low back pain?

The cause of acute low back pain may not be known. The pain may come from any part of the lower spine. Any of the following can cause acute low back pain:

  • Lumbar strain or sprain: This is the most common cause of acute low back pain. It is caused by the overstretching of the muscles, tendons, ligaments, and nerves in your lower back.

  • Degenerative changes: As you age, your spine may go through degenerative (breaking down) changes. These include degenerative disc disease (DDD) and arthritis in the facet joints of the vertebrae. The facet joints are where 2 vertebrae meet, in back of the spinal cord. DDD includes damage to the disc sac and loss of the fluid that fills the sac.

  • Disc herniation: This is also called a ruptured or slipped disc. When your disc herniates, there is a weak area that bulges out of the disc. This can press on nerves and irritate them, causing pain and numbness.

  • Fractures: These are bone breaks in the vertebrae of your spine. This can happen with injury or aging.

  • Spinal stenosis: This is narrowing of the spinal canal in your lower back. The spinal canal is the space in the vertebra where the spinal cord sits. The canal can be narrowed by a bone overgrowth or a soft tissue, such as a disc, pushing into it.

  • Spondylolisthesis or spondylolysis: Spondylolisthesis is when a vertebra slips out of place. Spondylolysis is a defect in the back part of the spine. These are congenital conditions you may be born with.

What increases my risk for acute low back pain?

If you have had acute low back pain before, you are at risk of getting it again. The following factors may also increase your risk:

  • Age 50 years or older

  • Medical conditions, such as obesity, pregnancy, scoliosis (abnormal spine curve), or weak stomach muscles

  • Diseases, such as arthritis or osteoporosis (brittle bones)

  • Repetitive injuries that happen when you often move or position yourself in a certain way

  • Bad posture while sitting or standing

  • Driving, sitting, or standing for long periods

  • Lifting heavy objects often, or lifting in a forward bent and twisted position

  • Steroid treatment for a long time, especially for older people

What are the signs and symptoms of acute low back pain?

You may have one or more of the following:

  • Back stiffness or spasms (sudden tightening of your back muscles)

  • Pain down the back or side of one leg

  • Holding yourself in an unusual position or posture to decrease your back pain

  • Not being able to find a sitting position that is comfortable

  • Slow increase in your pain for 24 to 48 hours after you stress your back

  • Tenderness on your lower back or severe pain when you move your back

How is acute low back pain diagnosed?

Your healthcare provider will ask about your medical history and examine you. He may ask when you last had low back pain and how it started. Show him where you feel the pain and what makes it feel better or worse. Tell him about the type of pain you have, how bad it is, and how long it lasts. Tell him if your pain worsens at night or when you lie down on your back.

How is acute low back pain treated?

The goal of treatment is to relieve your pain and prevent it from returning. Most people with acute lower back pain get better within 6 to 12 weeks. You may need any of the following:

  • Medicines:

    • Muscle relaxers help decrease pain and muscle spasms.

    • NSAIDs help decrease swelling and pain or fever. This medicine is available with or without a doctor's order. NSAIDs can cause stomach bleeding or kidney problems in certain people. If you take blood thinner medicine, always ask your healthcare provider if NSAIDs are safe for you. Always read the medicine label and follow directions.

    • Pain medicine: You may be given a prescription medicine to decrease severe pain if other pain medicines do not work. Take the medicine as directed. Do not wait until the pain is severe before you take your medicine.

    • Steroids: This medicine may be given to decrease inflammation.

  • Physical therapy: A physical therapist teaches you exercises to help improve movement and strength, and to decrease pain.

  • Surgery: This is done when you have severe back and leg pain. It may be offered if other treatments did not work. Surgery may be needed for conditions of the lumbar spine, such as herniated disc or spinal stenosis. Ask your healthcare provider for information about these diseases and the type of surgery that you may need.

What can I do to prevent low back pain?

  • Exercise: Gentle exercise may help decrease your pain. Start with some light exercises such as walking, biking, or swimming during the first 2 weeks. Ask for more information about the activities or exercises that are right for you.

  • Maintain a healthy weight: Ask for support or more information if you need help losing weight.

  • Sleep on a firm mattress: If you do not have a firm mattress, have someone move your mattress to the floor for a few days. Do not move the mattress onto the floor yourself as you will risk further injury. A piece of plywood or bed board under your mattress can also help make it firmer.

  • Ice: Ice helps decrease swelling, pain, and muscle spams. Put crushed ice in a plastic bag. Cover it with a towel. Place it on your lower back for 20 to 30 minutes every 2 hours. Do this for about 2 to 3 days after your pain starts, or as directed.

  • Heat: Heat helps decrease pain and muscle spasms. Start to use heat after treatment with ice has stopped. Use a small towel dampened with warm water or a heating pad, or sit in a warm bath. Apply heat on the area for 20 to 30 minutes every 2 hours for as many days as directed. Alternate heat and ice.

When should I contact my healthcare provider?

Contact your healthcare provider if:

  • You have a fever.

  • You have pain at night or when you rest.

  • Your pain does not get better with treatment.

  • You have pain that worsens when you cough, sneeze, or strain your back.

  • You suddenly feel something pop or snap in your back.

  • You have questions or concerns about your condition or care.

When should I seek immediate care?

Seek care immediately or call 911 if:

  • You have severe pain.

  • You have sudden stiffness and heaviness on both buttocks down to both legs.

  • You have numbness or weakness in one leg, or pain in both legs.

  • You have numbness in your genital area or across your lower back.

  • You cannot control your urine or bowel movements.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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