Back Pain (Acute or Chronic) 

Image of the spine showing cervical curve, thoracic curve, lumbar curve, sacrum, and coccyx

Back pain is one of the most common problems. The good news is that most people feel better in 1 to 2 weeks, and most of the rest in 1 to 2 months. Most people can remain active.

People who have pain describe it differently—not everyone is the same.

  • The pain can be sharp, stabbing, shooting, aching, cramping or burning.

  • Movement, standing, bending, lifting, sitting, or walking may worsen pain.

  • It can be limited to one spot or area, or it can be more generalized.

  • It can spread upwards, to the front, or go down your arms or legs (sciatica).

  • It can cause muscle spasm.

Most of the time, mechanical problems with the muscles or spine cause the pain. Mechanical problems are usually caused by an injury to the muscles or ligaments. Illness can cause back pain, but it's usually not caused by a serious illness. Mechanical problems include: 

  • Physical activity such as sports, exercise, work, or normal activity

  • Overexertion, lifting, pushing, pulling incorrectly or too aggressively

  • Sudden twisting, bending, or stretching from an accident, or accidental movement

  • Poor posture

  • Stretching or moving wrong, without noticing pain at the time

  • Poor coordination, lack of regular exercise (check with your doctor about this)

  • Spinal disc disease or arthritis

  • Stress

Pain can also be related to pregnancy, or illness like appendicitis, bladder or kidney infections, pelvic infections, and many other things.

Acute back pain usually gets better in 1 to 2 weeks. Back pain related to disk disease, arthritis in the spinal joints, or narrowing of the spinal canal (spinal stenosis) can become chronic and last for months or years.

Unless you had a physical injury such as a car accident or fall, X-rays are usually not needed for the first assessment of back pain. If pain continues and does not respond to medical treatment, you may need X-rays and other tests.

Home care

Try this home care advice:

  • When in bed, try to find a position of comfort. A firm mattress is best. Try lying flat on your back with pillows under your knees. You can also try lying on your side with your knees bent up toward your chest and a pillow between your knees.

  • At first, don't try to stretch out the sore spots. If there is a strain, it's not like the good soreness you get after exercising without an injury. In this case, stretching may make it worse.

  • Don't sit for long periods, as in a long car ride or during other travel. This puts more stress on the lower back than standing or walking.

  • During the first 24 to 72 hours after an acute injury or flare up of chronic back pain, apply an ice pack to the painful area for 20 minutes and then remove it for 20 minutes. Do this over a period of 60 to 90 minutes or several times a day. This will reduce swelling and pain. Wrap the ice pack in a thin towel or plastic to protect your skin.

  • You can start with ice, then switch to heat. Heat (hot shower, hot bath, or heating pad) reduces pain and works well for muscle spasms. Heat can be applied to the painful area for 20 minutes then remove it for 20 minutes. Do this over a period of 60 to 90 minutes or several times a day. Don't sleep on a heating pad. It can lead to skin burns or tissue damage.

  • You can alternate ice and heat therapy. Talk with your doctor about the best treatment for your back pain.

  • Therapeutic massage can help relax the back muscles without stretching them.

  • Be aware of safe lifting methods and don't lift anything without stretching first.

Medicines

Talk to your doctor before using medicine, especially if you have other medical problems or are taking other medicines.

  • You may use over-the-counter medicine as directed on the bottle to control pain, unless another pain medicine was prescribed. If you have chronic conditions like diabetes, liver or kidney disease, stomach ulcers, or gastrointestinal bleeding, or are taking blood thinners, talk to your doctor before taking any medicine.

  • Be careful if you are given a prescription medicines, narcotics, or medicine for muscle spasms. They can cause drowsiness, affect your coordination, reflexes, and judgement. Don't drive or operate heavy machinery.

Follow-up care

Follow up with your healthcare provider, or as advised. 

If X-rays were taken, you will be told of any new findings that may affect your care

Call 911

Call 911 if any of the following occur:

  • Trouble breathing

  • Confusion

  • Very drowsy or trouble awakening

  • Fainting or loss of consciousness

  • Rapid or very slow heart rate

  • Loss of bowel or bladder control

When to seek medical advice

Call your healthcare provider right away if any of these occur: 

  • Pain becomes worse or spreads to your legs

  • Weakness or numbness in one or both legs

  • Numbness in the groin or genital area

© 2000-2021 The StayWell Company, LLC. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.
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