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Lower Back Pain


Most people will have at least one episode of low back pain during their lifetime. Although nearly 90% of cases improve or resolve on their own, sudden onset low back pain can last up to a few weeks and can be extremely frustrating when the pain interferes with daily life.


Causes

The vast majority (more than 85%) of cases of sudden-onset of lower back pain is not clearly caused by a specific disease, abnormality, or serious injury of the spine. People sometimes refer to “throwing out” their back following physical activity. This pain is often caused by a strain in the muscles of the lower back.


Some of the other musculoskeletal causes of acute low back pain include:

  • Muscle spasm

  • Strain or tears to the ligaments supporting the back

  • Ruptured or herniated disk

  • Compression fracture of spine

  • Traumatic injury to the muscle, ligament, or spine

  • Cancer involving the spine

  • Infection of the spine

  • Arthritis


When to see a doctor

Most muscle sprains of the lower back pain gradually improves with self care within a few weeks.


A doctor should evaluate the back pain if it:

  • Persists past a few weeks

  • Causes weakness, numbness, or tingling in one or both legs

  • Is severe and does not improve with rest

  • Spread down one or both legs, especially if the pain extends below the knee

  • Is accompanied by unexplained weight loss or if you have a history of cancer

  • Burning with urination or blood in the urine


Immediate medical evaluation should be sought if the back pain:

  • Causes new bowel or bladder problems

  • Is accompanied by a fever

  • Follows a fall, blow to back, or other injury


Diagnosis

Evaluation of the back pain beings with a thorough clinical history and physical examination. Imaging studies such as X-ray, CT scan, or MRI of the lower spine are not routine but may be ordered to rule out specific causes of pain.


Self Care Management

Unless there are symptoms that warrant immediate medical evaluation or evaluation by a doctor, self care methods are helpful for the initial management of sudden onset lower back pain. 


Self care management includes:

  • Apply ice to the area in the first 48 to 72 hours, then apply heat

  • Reduce physical activity for the first few days. Bed rest is not recommended, so continue activities as tolerated.

  • Take over-the-counter pain relievers. Do not exceed the recommended amount per package instructions.

  • Stress reduction with relaxation and meditation


If the low back pain worsens or does not improve after two to three weeks of home treatment, contact the doctor for evaluation and further treatment options.




References

https://medlineplus.gov/ency/article/007425.htm

https://www.uptodate.com/contents/low-back-pain-in-adults-the-basics

https://www.mayoclinic.org/diseases-conditions/back-pain/diagnosis-treatment/drc-20369911

https://www.aans.org/en/Patients/Neurosurgical-Conditions-and-Treatments/Low-Back-Pain