Emergency Care For You

Back Pain

Acute back problems may be experienced by almost everyone at some point in their lives. There are many causes of back pain, including accidents, muscle strains, sports injuries; acquired nerve, disc or muscle disorders; mechanical problems involving the spine; and infections and tumors.

Back pain is more common among older adults, but it is also the most prevalent cause of disability for people under age 45 (usually from accidents, sports injuries or work-related exertion injuries).

Symptoms of back pain include:

  • persistent aching or stiffness at any point along the spine from the neck to the tailbone;
  • sharp, localized pain that may occur after lifting heavy objects or overexerting oneself during sports activities; or
  • a chronic ache in the middle or lower back, especially following long periods of sitting or standing. 

Lower Back Pain

Back problems can occur anywhere along the spine but are more common in the lower part, which supports most of the body’s weight.

The best ways to prevent lower back problems include staying fit, avoiding situations involving repetitive or extensive heavy lifting, and doing regular, appropriate exercise. If you lift a heavy object, for instance, be sure to keep it close to your body and avoid lifting while twisting, bending forward or reaching. Listen to your body. If a motion or activity hurts, obey your body’s pain signals. In time you most likely will be able to do most everything you could do before the back problems began, as long as you allow your body to heal.

Most cases of lower back pain are caused by minor injuries or strained muscles or ligaments in the back. For most people, the pain usually gets better in a few days or weeks, although more than half who recover will have another episode within a few years. Over-the-counter pain relievers such as aspirin, acetaminophen, ibuprofen or naproxen sodium can help. A firmer mattress may provide some relief, and maintaining a moderate level of activity can help recovery. Apply heat to the painful area or try alternating between hot and cold packs.

Usually lower back pain can be treated without surgery, and understanding its cause often is key to avoiding re-injury. Treatment often involves using analgesics, reducing inflammation, restoring proper function and strength to the back, and preventing recurrence. You may also need physical therapy, or your doctor may recommend back exercises. Bed rest is no longer recommended for back pain and may delay recovery. In addition:

  • Avoid straining or stretching and any intense physical activity, particularly heavy lifting and trunk twisting.
  • Consider using supportive back belts, braces, or corsets, but only briefly, since they can reduce muscle tone over time.
  • Wear comfortable shoes.
  • Use a chair with support and rest your feet on the floor or on a low stool if you must sit for long periods of time.
  • Try lying curled up in a fetal position with a pillow between yours knees or on your back with a pillow under your knees.
  • Try resting one foot on a low stool if you must stand for long periods of time.
  • Try using a pillow or rolled-up towel behind the small of your back if you must drive long distances

Contact your doctor if you don’t see a noticeable reduction in pain and inflammation after 72 hours of self-care.

You should also consider seeking medical attention if:

  • the pain is severe even after taking medication and getting rest;
  • if the pain follows a fall or an injury;
  • if you have numbness, tingling or loss of control in your arms or your legs (a possible indication of spinal-cord injury);
  • the pain is made worse by coughing or bending forward at the waist (a possible sign of a herniated disc);
  • the pain extends downward along the back of the leg (a possible sign of sciatica);
  • if you experience unintentional weight loss;
  • you are over 50 and experience dull pain in one area of your spine while lying down or upon rising (a possible sign of osteoarthritis).

Seek emergency care if:

  • pain is accompanied by weakness in the legs or a loss of sensation in the groin or rectal area;
  • back pain is associated with loss of bowel or bladder control, trouble urinating; or
  • fever, chills or other signs of infection are involved.

Remember, you can often help prevent back problems from becoming more serious by taking care of your back and helping yourself get back to your regular activities.