Low Back Pain: Causes, Home Care and When to Be Seen

What it involves

MedlinePlus says back pain is one of the most common medical problems, affecting 8 out of 10 people at some point in their lives, and that it can range from a dull, constant ache to a sudden, sharp pain. Acute back pain comes on suddenly and usually lasts from a few days to a few weeks. MedlinePlus calls it chronic if it lasts for more than three months.

Who this is for

• Adults with back pain that has not improved after a few days to a few weeks
• Patients whose pain followed lifting, twisting, a fall, or a long stretch of sitting
• Patients with pain that spreads into the buttock, hip, or leg
• Patients who want to know whether joint injections or other treatment could fit their situation

What to expect

• Questions about when the pain started, what makes it better or worse, and any recent injury
• A physical exam of your back, hips, and legs
• A talk about home care, pain medicine, activity, and when to return
• A decision about whether more tests or a specialist visit make sense

What is inside the back

NIAMS says many structures work together to support the body, including the vertebrae, the spinal cord, the discs that act as shock absorbers, ligaments, tendons, and muscles, and that a problem with any one of them can cause back pain. It describes a sprain as an injury to the ligaments and a strain as an injury to a muscle or tendon, often from twisting or lifting improperly.

Other causes NIAMS lists

NIAMS says causes can overlap, and that sometimes no specific cause is found. A kidney problem is one reason pain in the back can start somewhere else, which the urinary tract infection page touches on. NIAMS also lists: Stiffness higher up in the spine is covered in the neck pain evaluation, which lists everyday strain, arthritis, and the signs that need 911.

• Herniated or ruptured discs that irritate nearby nerves
• Degenerative disc disease and spinal stenosis, which come with aging
• Osteoporosis, which can lead to painful fractures of the vertebrae
• Kidney stones or kidney infections
• Fibromyalgia, a condition of widespread muscle pain and fatigue
• Pregnancy, and in rare cases infection or tumors

Who is more likely to have it

NIAMS says back pain is more common with low fitness, weight gain, jobs that involve heavy lifting or long hours of poor sitting posture, chronic stress or poor sleep, depression or anxiety, and age, especially after 45. Heredity plays a role in some conditions that cause back pain. The obesity and BMI guide covers the weight side of that list.

What helps at home

MedlinePlus says most back pain goes away on its own, though it may take a while. Over-the-counter pain relievers and resting can help, but staying in bed for more than one or two days can make it worse. MedlinePlus lists hot or cold packs, exercise, medicines, injections, complementary treatments, and sometimes surgery as treatments, depending on the cause. Check with your provider before combining pain medicines. Pain that shows up in the elbow after repeated gripping or twisting is a separate problem, and the elbow pain guide explains the rest and ice steps MedlinePlus suggests for it.

Where joint injections fit

Some back and joint pain is a good fit for treatment a primary care provider can offer. The practice lists joint injections among its services, and the joint injections page explains what a first conversation about them looks like. An injection is one option among several, and a provider decides after an exam whether it makes sense for you. Pain in the knee is a different question from back pain, and the knee pain evaluation describes its common causes and when to be seen. Joint pain higher up the body is common too, and the shoulder pain evaluation lists the rotator cuff problems and other causes that can make lifting an arm overhead hurt.

Signs that mean be seen sooner

MedlinePlus says to call your provider if back pain is severe or does not improve after three days, or follows an injury. NIAMS says to see a doctor if pain does not improve after a few weeks, or comes with numbness or tingling, trouble urinating, weakness or numbness in the legs, fever, or weight loss you did not intend. If you are unsure where to go, the sick visit, urgent care, or ER guide can help you decide. Pain felt in the hip or buttock can start in the back, and the hip pain evaluation explains when hip pain is felt in the groin instead and what that can point to. When back pain travels down the back of one leg or comes with numbness, the sciatica guide explains the pinched-nerve causes MedlinePlus lists and the warning signs for a prompt visit.

Sources

• MedlinePlus — Back Pain
• NIAMS — Back Pain