Low Back Pain
How should you treat low back pain?
Most people can get over back pain in a few weeks. These simple steps might help.
- Stay active. Resting in bed for more than a day or so can cause stiffness, weakness, depression and slow recovery.
- Apply heat. Heat can temporarily reduce pain and relax muscles to make stretching easier but does not necessarily speed long-term recovery.
- Consider over-the-counter medicines. Good options include pain relievers such as acetaminophen (Tylenol) or anti-inflammatory drugs such as ibuprofen (Advil) and naproxen (Aleve).
- Sleep comfortably. Lay on your side with a pillow between your knees or on your back with a few beneath your knees.
Imaging tests for low back pain— when you need them and when you don’t
- Talk with your doctor. If symptoms don’t improve after a few days, contact your doctor to make sure that the symptoms are not caused by a serious health problem. If the pain is severe, ask about prescription pain relievers.
- Consider alternatives. If you don’t feel better after four weeks or so, it might be worth talking with your doctor about other options. This can include physical therapy, chiropractic care, yoga, massage, acupuncture, cognitive-behavioral therapy and progressive muscle relaxation. More invasive choices, like surgery, should be considered only if those other treatments don’t help.
Back pain can be excruciating, so it seems that getting an X-ray, CT scan or MRI to find the cause would be a good idea. That is usually not the case, at least not at first. This is because:
When do imaging tests make sense?
- They don’t help you get better faster. Most people with lower back pain feel better in about a month whether they get an imaging test or not.
- They can pose risks. X-rays and CT scans expose you to radiation. It is best to avoid radiation when you can.
- They are often a waste of money. Imaging tests range from about $200 to $1,600. Imaging also accounts for a big chunk of the billions Americans spend on low back pain each year.
It can be a good idea to get an imaging test right away if you have signs of severe or worsening nerve damage or a serious problem like cancer or a spinal infection. Red flags that can make testing worthwhile include:
- A history of cancer
- Unexplained weight loss
- Recent infection
- Loss of bowel or bladder control
- Abnormal reflexes
- Loss of muscle power or feeling in the legs
In other cases, you probably don’t need an imaging test for at least several weeks after the onset of your back pain. This is only after you have tried the self-care measures described above.