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Most people with acute low back pain respond very rapidly to treatment; 90 percent are free of symptoms within one to two weeks. Many of the remaining 10 percent recover within three months.
Acute low back pain is a common problem, with pain in the low back for less than 4 to 6 weeks. It is often called acute mechanical back pain, because the source of the pain may be in the spinal joints, discs, vertebrae, or soft tissues. Acute low back pain may also be called lumbago, idiopathic low back pain, lumbosacral strain or sprain, or lumbar syndrome.
The cause of acute low back pain may only be identified 20 percent of the time—when a specific trauma or strenuous activity may have caused the pain. Most of the time, however, the specific source cannot be found. "Mechanical" back pain implies that the source of the pain is in the spine and/or its supporting structure. The surrounding muscles and ligaments may become inflamed and irritated. Less than 1 percent of people who develop acute low back pain have a serious cause, such as cancer or infection, to explain their pain.
Most people with this spinal problem experience pain primarily in their lower back. The pain may spread to the buttocks, thighs or knees. Many people may also experience muscle spasms. The symptoms are generally more noticeable when bending or arching the back or when lifting heavy objects.
Back pain is usually more severe than leg pain (sciatica). Sciatica is usually the result of a pinched nerve, when a protruding disc is putting pressure on a spinal nerve. With sciatica, the pain frequently extends below the level of the knee.
A careful evaluation of your medical history and a physical examination will help your health care providers determine if you have acute low back pain. If so, they will work with you to develop an appropriate treatment plan. Additional testing is not usually necessary.
Nonsurgical treatment with limited activity, pain medication, and a supervised therapy or chiropractic program is the recommended treatment for acute low back pain. Restricted activity for a brief period (usually less than 48 hours) is recommended for patients with severe back pain and muscle spasms.
Physical activity is recommended early to promote rapid recovery from back pain. For moderate to mild back pain, we recommend a near-normal schedule from the onset. Applying ice, then heat is helpful to relax the muscles and decrease muscle inflammation. We generally recommend that you apply ice for the first 48 hours, followed by heat.
If you have spasms, a muscle relaxant may be prescribed for a short time (3-4 days). Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen are frequently prescribed. They relieve pain and decrease muscle inflammation. If the pain is severe, your health provider may prescribe an analgesic that can be taken with the NSAID or muscle relaxant.
In many cases, active physical therapy is an essential part of acute back pain rehabilitation. Massage, ultrasound, diathermy, heat and traction may also be recommended for short periods. Many patients may also benefit from chiropractic manipulation.
We usually recommend that patients return to work promptly. If their regular job cannot be done initially, it is in the patient's best interest to return to some kind of modified duty (light or restricted duty). Your health care provider can give prescriptions for such activity for limited periods of time.
Most people with acute low back pain respond very rapidly to treatment; 90 percent are symptom-free within one or two weeks. Many of the remaining 10 percent recover within three months. A positive mental attitude, regular activity, and a prompt return to work are all very important elements of this recovery. Recurrences of back pain are common. Continuing your home exercise program may help reduce the risk of another episode.
For more information on Acute Low Back Pain, click here.
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