Low back pain is one of the most common problems in the U.S. As a matter
of fact, more than 80 percent of Americans experience at least one episode
of low back pain (LBP) in their lifetimes. Usually this pain is not serious
and goes away on its own.
Most people experience “nonspecific LBP,” which means there
is not a specific spine problem causing the pain. Rarely is back pain
caused by a potentially serious condition.
In some situations, people experiencing LBP should be managed by their
primary care provider, such as a family physician, internist, nurse practitioner
or physician assistant. However, those with low back pain should call
their primary care provider immediately if any of the following apply:
- Weakness in one or both legs or problems with bladder, bowel, or sexual function;
- Pain accompanied by unexplained fever or weight loss;
- New back pain occurring in an individual age 70 or older;
- The pain is the result of a fall or an accident, especially if you are
age 50 or older;
- Pain that radiates into the leg, especially when accompanied by weakness;
- If you have been diagnosed or treated for cancer, weakened immunity or
- If you have used corticosteroids for a prolonged period; or
- If the pain does not improve within four weeks.
Factors that increase your risk for LBP include being older; being female;
physically strenuous work and/or sedentary work. Additional risk factors
include smoking, obesity, job dissatisfaction and high levels of anxiety.
Unless LBP is caused by a serious medical condition, a rapid recovery
is expected, even in cases of a herniated disc. Care during an acute episode
Stay active. Staying active will not delay your recovery or cause further injury.
Moving can prevent loss of muscle strength and spasms. High-impact activities
should be avoided during acute episodes, but light exercise and day-to-day
activities can be continued. Avoid prolonged sitting or standing, heavy
lifting, and twisting.
Use heat. A heating pad can help relieve LBP during the first few weeks.
Use over-the-counter pain medications. Try medications such as aspirin, acetaminophen, ibuprofen, or naproxen.
These are usually more effective if you take them regularly for the first
three to five days, instead of only using them when the pain cannot be
Exercise. After the first few days, exercise, such as walking, swimming, stationary
bicycle, or low-impact aerobics, can increase flexibility and strengthen
your core muscles. While this may temporarily increase your pain, often
it will reduce the duration of pain and prevent recurrent episodes, especially
if you continue the program indefinitely. You should avoid activities
that involve twisting and bending or that are high impact.
Physical therapy. If you continue to have LBP for more than four to six weeks, your healthcare
provider may refer you to physical therapy to evaluate and develop a formal
Steroid injections. In some cases, your healthcare provider may refer you to a specialist
for evaluation for epidural steroid injections. These can reduce swelling
and inflammation, and thereby reduce pain. King’s Daughters physical
medicine/rehabilitation specialists, anesthesiologists, and interventional
radiologists can provide these services.
Other therapies. Some people with LBP find benefit in acupuncture or massage. Yoga, as
well as other restorative exercise programs, can also sometimes provide relief.
You can prevent future episodes of low back pain by staying active and
performing exercises such as walking and yoga to stretch your back. Exercises
that strengthen the muscles of the hip and abdomen are important in supporting
the lower back and preventing pain. Learning proper bending and lifting
techniques will also help to avoid future LBP. Finally, if you sit or
stand in the same position for long periods of time you should change
positions frequently or take short breaks.