Acute Low Back Pain
Written by Robert A Wilson   
Sunday, 11 February 2007

Acute low back pain has many possible causes but the most common is muscle strain. Pain can start immediately after a specific event, such as twisting, or bending over at the waist; or it may not start until several hours later. In some cases pain can occur for no apparent reason. At times the symptoms become a cycle of events: muscle spasm which causes pain, which results in more muscle spasm. Besides muscle strain, possible causes include a ruptured disk, osteoporosis, spondylosis (hardening and stiffening of the spinal column), nerve dysfunction, infections, or injury due to a fall or a blow. In most cases, low back pain goes away in a few days and nearly all cases of low back pain are resolved within 4 weeks. Risk increases with sedentary occupations; obesity; poor posture and muscle tone; poor general physical fitness; strenuous, infrequent physical activity such as occasional sports participation or yard work; use of poor body mechanics, such as poor lifting techniques; and wearing high heel shoes.


Symptoms may include:

  • Pain
  • Stiffness
  • Numbness, weakness, or problems with coordination

What your doctor can do:

  • Obtain a history and do a physical exam.
  • 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 prior to surgery.
  • Prescribe any of several medications to relieve symptoms.

What you can do:

  • For the first 24 hours, apply ice for 15-20 minutes at a time several times a day; reduce your activity level; avoid lifting or bending; take prescription or over-the-counter medications for inflammation (e.g., ibuprofen, aspirin, naproxen), pain, and muscle spasms; and perform prescribed exercises. Bed rest is not usually necessary although in some cases your doctor may recommend it for the first 24 hours or, if you have had a severe injury. Gentle massages may help.
  • After the first 24-48 hours, heat therapy, instead of ice, may provide relief. 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 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.

Contact your 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 weeks; you may want to discuss other treatment options with your doctor. These may include electrical nerve stimulation, acupuncture, or chiropractics. 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, have difficulty going to the bathroom, or lose bowel or bladder control.

Last Updated ( Friday, 08 February 2008 )