Treatment Options For Acute Lower Back Pain
Most low back pain is due to muscle strain and spasm and does not require surgery. To treat the pain, medications such as acetaminophen , nonsteroidal anti-inflammatory agents , gabapentin or pregabalin can be used. NSAIDs suppress inflammation, pain and fever by inhibiting certain inflammation-causing chemicals in the body. Acetaminophen reduces pain and fever, but does not inhibit inflammation. Gabapentin and pregabalin, medications that have been used for antiseizure activity, also have the ability to block pain. Opioids provide pain relief and may at times be prescribed to manage severe back pain. However, opioids have many problems, such as habituation, constipation and lightheadedness, and are avoided when possible and used for the shortest possible duration. Epidural injection is an option if the back pain does not respond to these treatments. Each person is different in terms of response to medication.
Other nonsurgical treatments for lower back pain include Intradiscal electrothermal therapy , nucleoplasty, and radiofrequency lesioning.
Dysfunction Of Sacroiliac Joints
Dysfunction of the sacroiliac joints is also called sacroiliitis. You have two sacroiliac joints, one on each side of your spine where it connects with the top of your pelvis. Sacroiliitis is inflammation of this joint. It can affect one or both sides.
Pain in your lower back and buttocks is the most common symptom. The pain is usually made worse by:
- unexplained weight loss
- pain after a fall or injury
If you need help finding a primary care doctor, you can browse doctors in your area through the Healthline FindCare tool.
How Is Lower Back Pain Diagnosed
Your provider will ask about your symptoms and do a physical exam. To check for broken bones or other damage, your provider may order imaging studies. These studies help your provider see clear pictures of your vertebrae, disks, muscles, ligaments and tendons.
Your provider may order:
- Spine X-ray, which uses radiation to produce images of bones.
- MRI, which uses a magnet and radio waves to create pictures of bones, muscles, tendons and other soft tissues.
- CT scan, which uses X-rays and a computer to create 3D images of bones and soft tissues.
Electromyography to test nerves and muscles and check for neuropathy , which can cause tingling or numbness in your legs.
Depending on the cause of pain, your provider may also order blood tests or urine tests. Blood tests can detect genetic markers for some conditions that cause back pain . Urine tests check for kidney stones, which cause pain in the flank .
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% Of People Will Experience Back Pain At Some Time But There Are Ways To Find Relief
As people enter middle age, they are more likely to experience bouts of low back pain. In fact, according to the Harvard Special Health Report Men’s Health: Fifty and Forward, back pain affects about four in five Americans at some point in their lives and equally strikes men and women.
Age is often the culprit. Over time, the bones and joints in your lower back begin to change. Your discs tend to wear out and sometimes become fragmented. These structural alterations sometimes cause pain.
Another cause of low back pain, although it occurs less often, is a herniated disc. Sometimes, a disc pushes outside the space between the bones and compresses a nerve at the point where it branches off the spinal cord. When the sciatic nerve that leads into the buttocks and leg is affected, the pain is called sciatica.
Yet, most cases of low back pain stem from strain or sprain due to simple overuse, unaccustomed activity, excessive lifting, or an accident. In most cases the best move is to wait and see if the pain resolves on its own. If the pain does not improve after three to four days, then it’s time to see a doctor.
However, depending on the source of your back pain and its severity, you might try a few home remedies for low back pain to help ease the pain until your back returns to normal. Here are several options to consider:
Complementary therapies. Several types of complementary therapy may be helpful for relief from low back pain. These include:
Dont Perform Certain Exercises
If you are involved in sports, you should immediately stop playing until your back heals or until your chiropractor gives you the OK to continue. Walking, swimming and low-impact aerobics are all back-friendly exercises you can enjoy.
Lower back pain exercises you should avoid include:
- Toe touches
- Lifting weights
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Bonus Tip: Soothe The Pain With Cold And/or Hot
Don’t underestimate the pain reduction of simply applying cold packs and/or hot packs to help reduce your lower back pain.
- Cold therapy helps reduce inflammation and pain. Some examples include wrapping ice in a cloth, a pack of frozen peas from the freezer, or a cold gel pack. Always keep at least one layer between your skin and the ice/cold pack.
- Heat therapy helps improve blood flow, relaxation, and pain relief. Heat therapy can come in many forms. It’s best to try several to find what works best for you. Taking a warm bath or shower, soaking in a hot tub, or using a heating pad or heat wrap are all ways to bring warmth to your lower back.
Whether applying ice or a heat pack, limit applications to 15 or 20 minutes with at least 2 hours of rest in between to protect your skin. Never sleep with a heating pad or frozen pack as this can lead to permanent skin damage.
Hopefully these overlooked remedies can help you try some new approaches to better manage your lower back pain and find lasting relief.
Could Lower Back Pain Be Kidney Pain
It absolutely can. Kidneys are located on the back side of your body and kidney pain can sometimes feel like back pain. The only true way to tell the difference is to visit a doctor who can conduct a thorough examination.
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When Should You Seek Treatment For Acute Or Chronic Back Pain
Whether you think your back pain is acute or chronic, anytime youre experiencing pain that lasts longer than two weeks without any improvement in symptoms, we strongly suggest you get the care you need.
If you think you need care right away, you can also go to your nearest orthopedic urgent care location.
If the pain is new or you know youve tweaked something, a great place to start is to find a physical therapy location and make an appointment. Our physical therapists will tailor strengthening and mobility exercises to your unique needs, and you can plan on about six visits.
That said, acute back pain will usually heal itself over a few weeks. But chronic pain usually doesnt get better without medical intervention. Why? While home remedies and short-term back pain treatments are helpful, they provide temporary relief and dont address those underlying causes of chronic pain.
So, if youre regularly experiencing signs of chronic back pain, dont ignore it. While chronic pain is long-lasting, it doesnt have to be permanent and you probably dont need surgery. This is where TRIA Neck and Back Strengthening Program, formerly known as the Physicians Neck and Back Center spinal strengthening program can help.
When Should I See My Healthcare Provider About Lower Back Pain
Lower back pain usually gets better with rest and pain relievers. Back pain that doesnt go away may be a sign of a more serious condition.
See your provider if you have:
- Pain that doesnt get better after about a week of at-home care.
- Tingling, numbness, weakness or pain in your buttocks or legs.
- Severe pain or muscle spasms that interfere with your normal activities.
- Fever, weight loss, bowel or bladder problems or other unexplained symptoms.
A note from Cleveland Clinic
Millions of people live with low back pain. Stiffness, pain and limited movement can have a major impact on quality of life. But you may be able to avoid lower back pain by maintaining a healthy weight and staying active. Talk to your provider if back pain doesnt go away or if youre unable to do the activities you enjoy. Several treatments can relieve pain, help you move better and get more out of life.
Last reviewed by a Cleveland Clinic medical professional on 01/18/2021.
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What Are Some Other Causes Of Lower Back Pain
The shape of your spine, and well as spinal diseases, are other culprits in lower back pain. Depending on a range of factors, your doctor may look for:
Abnormal spinal curvature. A normal spine resembles a gently curved letter S when seen from the side. Abnormal curves include:
Lordosis, in which the spine curves too far inward at the lower back
Kyphosis, in which the spine is abnormally rounded in the upper back
, in which the spine curves from side to side, often in a C shape
Normal and abnormal curves of the spine
Arthritis. There are more than 100 types of arthritis, many of which can cause lower back pain. The most common types include osteoarthritis , , and .
. Compression of the bundle of nerves that forms below the spinal cord in the lumbar spine. It is a rare but serious disorder that requires immediate medical attention and possibly emergency surgery. CES got its name from the fact that the fanned-out bundle of nerves resembles the base of a horses tail.
. Both infections of discs and bone can cause severe pain and require prompt medical attention.
. Your bones lose mass faster than it can be replaced, making them brittle. They can even fracture with little or no warning. These fractures are especially common in the spine, where theyâre called vertebral compression fractures. Both men and women lose bone mass as they age, but postmenopausal women lose it much faster and so are more at risk for osteoporosis.
What Are The Causes Of Lower Back Pain
The vast majority of patients experience back pain because of mechanical reasons. They strain a muscle from heavy lifting or twisting, suffer a sudden jolt in a car accident, experience stress on spinal bones and tissues resulting in a , or suffer from osteoarthritis, a potentially painful degeneration of one or more spinal joints. Common causes for low back pain are:
- mechanical or functional injury
- active infection
- referred pain
To choose the safest and most effective therapy, doctors need to consider the full spectrum of possible underlying issues, such as inflammatory conditions, fracture, infection, as well as some serious conditions unrelated to the back that radiate pain to the back.
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Dont Lie In Bed Or Couch Surf
We understand that back pain is sometimes so intense, you cant do anything but put your butt in between the couch cushions, put a pillow under your knees and hit up a Netflix marathon. This is OK for the first 24-48 hours, but after that, you are doing your back more harm than good.
What can you do for severe back pain? If you literally cannot walk, stand, or sit for more than a few minutes, even after 48 hours of bedrest, you should see your chiropractor immediately or go to the emergency room.
Rest for a short period of time, do some stretches, and get back on your feet!
What Is The Treatment For Chronic Nonspecific Low Back Pain
Initial treatment is similar to sudden-onset attacks. That is, aim to keep as active as possible. Also, painkillers can help. In addition to the painkillers listed above, your doctor may advise a course of an antidepressant medicine in the tricyclic group – for example, amitriptyline. Tricyclic antidepressants have other actions separate to their action on depression. They are used in a variety of painful conditions, including back pain.
Also, a national guideline , referenced below) recommends one or more of the following treatments should be considered. Each of these treatments has some evidence from research trials to suggest that they will help to ease symptoms in some people :
- Structured exercise programme. This means a programme of exercise supervised by a professional such as a physiotherapist. This is likely to be in a group setting. Exercises may include aerobic activity, movement instruction, muscle strengthening, posture control and stretching. It typically consists of up to eight supervised sessions over 8-12 weeks with encouragement to keep on doing the exercises at home between sessions.
- Manual therapy. Typically this includes several sessions of massage, spinal mobilisation and/or spinal manipulation. With spinal mobilisation the therapist moves the joints of the spine around in their normal movement range. In spinal manipulation, the therapist moves joints beyond the usual range of movement.
- A course of acupuncture. It is not clear how this may work.
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Which Lifestyle Factors Contribute To Lower Back Pain
There are three major lifestyle factors that may affect your chances of developing lower back pain:
- Multiple studies have established a link between smoking and lower back pain. Smoking raises inflammation inside the body and hinders the body from healing itself.
- Obesity is also associated with several types of chronic pain, including lower back pain. In people with high body mass index , the stress on the spine increases, contributing to even more wear and tear.
- Your level of physical activity can also play a role in your lower back health. While a sedentary lifestyle could increase your risk of developing lower back pain, so can excessive or strenuous physical activity. Check with your doctor if you are unsure about your ideal level of physical activity.
Maintain Correct Posture When Sitting
You can avoid lower back pain by maintaining proper posture when sitting. If you have a desk job, keep your feet planted on the floor and use a chair that provides lower back support. Also, avoid hunching forward to see your computer screen and reaching far in front of you to use your mouse or keyboard.
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Ways To Manage Low Back Pain At Home
Back pain is one of the most common physical ailments. Studies show that eight in 10 Americans have back pain at some point in their lives, usually in the lower back.
Your might have sprained it while working in the yard or cleaning house. Or your back might hurt from an old sports injury or a chronic condition such as arthritis or ankylosing spondylitis.
Sudden or severe back pain should be checked by a doctor or a physical therapist. That also goes for pain that wonât go away.
But sometimes you can treat nagging pain and discomfort on your own.
Wilson Ray, MD, chief of spine surgery for the Department of Neurological Surgery at Washington University School of Medicine in St. Louis, says home remedies â tend to be better when they’re combined than alone.â
What Exactly Is The Lower Back Anyway
Your lower back is known as the lumbar region of the spine. It has a lot of heavy lifting to do: The lumbar spine carries the weight of your entire upper body, plus biomechanical stresses that occur with movement.
The lumbar spine has five vertebraebackbones. Each vertebra has a large disc cushiony gel wrapped in a tough membrane on its front side that acts as a shock absorber. Each vertebra also has two cartilage-lined facet joints on its back side. Working together, discs and facet joints allow the spine to safely bend and twist.
Your lower back also includes ligaments, tendons, and muscles. Ligaments are strong bands that hold the vertebrae and discs together. Tendons attach muscles to the vertebrae. These structures help limit excessive movement that could harm the spinal cord.
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Other Types Of Diagnosis
- A chiropractor will diagnose through touch, or palpation, and a visual examination. Chiropractic is known as a direct approach, with a strong focus on adjusting the spinal joints. A chiropractor may also want to see the results of imaging scans and any blood and urine tests.
- An osteopath also diagnoses through palpation and visual inspection. Osteopathy involves slow and rhythmic stretching, known as mobilization, pressure or indirect techniques, and manipulation of joints and muscles.
- A physical therapist focuses on diagnosing problems in the joints and soft tissues of the body.
Maintain Correct Posture During Activities
To protect your lower back from injury, its important to maintain proper posture when performing physical activitiesespecially if you play sports or have a job that requires repetitive motions. Avoid slouching as much as possible and aim to keep your spine erect. When lifting, bend and straighten from the knees, not the waist. And be sure to move your hips when twisting from side to side.
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Less Common Causes Of Low Back Pain
Inflammation of the joints of the spine sometimes causes back pain. Osteoarthritis is the common form of arthritis and usually occurs in older people. Ankylosing spondylitis is another form of arthritis that can occur in young adults and which causes pain and stiffness in the lower back. Rheumatoid arthritis may affect the spine but you are likely to have other joints affected too.
Various uncommon bone disorders, tumours, infection and pressure from structures near to the spine occasionally cause low back pain .
The rest of this leaflet is mainly about nonspecific low back pain – the common type of low back pain.