The back pain may be constant or come and go. It may be worse with motion, sitting, standing, bending, and twisting. If a nerve is irritated, the pain may spread into the buttock or leg on one side. Muscle weakness or numbness may also occur.
When Should I Call My Doctor?
Some problems may need care right away. Call the doctor if you have:
Severe or worsening pain
Pain that lasts longer than one week
Problems walking, standing, or moving
Pain that is worse at night or when you lie down
Pain that spreads down your legs
Pain or throbbing in your belly
Back pain with:
Numbness, weakness, or tingling in the buttocks, genitals, or legs
Loss of bowel or bladder control
Fever, unexplained weight loss, or other signs of illness
The doctor will ask about symptoms and past health. A physical exam will be done. The exam will focus on the back, hips, and legs.
Imaging tests are rarely needed. They may be done for pain that is severe or does not get better with treatment.
Back pain often improves with home care and time. If the pain is new, steps that may help to ease pain include:
Staying away from movement that makes pain worse—absolute rest is rarely helpful.
Cold or hot compresses over the area
Medicines, such as:
Over the counter and prescription pain relievers
Topical pain relievers that are applied to the skin
Muscle relaxants to ease spasms
Avoid intense stretching or exercise
Physical therapy to improve strength, flexibility, and range of motion
Cognitive behavioral therapy to learn how to manage pain
Back pain can linger for longer periods of time. Steps that may help chronic back pain include:
Regular exercise program—avoid activities that make back worse
Stretching program, like yoga
Physical therapy—to improve strength and balance, find cause of problem
Heat when back is stiff
Other treatments that may be helpful include:
Spinal manipulation—specialist move spinal bones with controlled thrusts
Surgery may be needed for pain that is making day to day life difficult. Other treatments will be tried first before surgery. The type of surgery will depend on what is causing pain. Choices include:
Discectomy—remove damaged tissue between spinal bones, can relieve pressure on nerves.
Laminectomy—part if spinal bone is removed to ease pressure on nerves.
Acute low back pain. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/acute-low-back-pain. Accessed January 28, 2021.
Chronic low back pain. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/chronic-low-back-pain. Accessed January 28, 2021.
National Guideline Centre. Low back pain and sciatica in over 16s: assessment and management. London (UK): National Institute for Health and Care Excellence (NICE); 2016 Nov 30. 18 p.
12/14/2016 DynaMed Plus Systematic Literature Surveillance https://www.dynamed.com/condition/chronic-low-back-pain: Cherkin DC, Sherman KJ, Balderson BH, et al. Effect of mindfulness-based stress reduction vs cognitive behavioral therapy or usual care on back pain and functional limitations in adults with chronic low back pain: a randomized clinical trial. JAMA 2016;315(12):1240-1249.
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