Acute lower back pain is one of the most common reasons for medical visits in the U.S. Acute lower back pain starts suddenly, and improves within several weeks. 

Even though many cases of lower back pain aren’t concerning, others can be more serious. As such, patients need to know when to see a doctor. 

This guide from HealthTap explains everything patients should know about acute lower back pain, including its causes, diagnoses, and treatments.  

What is acute lower back pain?

Most people have back pain at least once in their life. Although this pain can happen anywhere in the back, it’s more common in the lower back because this body part supports the most weight. 

Acute lower back pain is short-lived. It comes on suddenly and lasts between six and 12 weeks. In many cases, acute lower back pain is nonspecific, meaning it’s not caused by another medical condition. 

Acute lower back pain is moderate to severe. Even though many cases resolve on their own, some patients may need medical treatment. 

Many patients with acute lower back pain don’t completely recover within six weeks and have to seek additional treatment. Even if the pain resolves, it may return within two years — observed in more than half of patients with the condition. 

What causes acute lower back pain?

A sudden muscle or ligament injury often causes acute low back pain. Many people experience lower back pain after lifting a heavy object or getting into a car accident. However, there are many other potential causes of back pain. 

• Skeletal abnormalities

Skeletal abnormalities may be present since birth, or they may develop over time. They include scoliosis (curvature of the spine), kyphosis (rounding in the upper back), and lordosis (rounding in the lower back).

• Spondylosis

Spondylosis is a type of arthritis that affects the spine. It occurs when the cartilage, joints, and bones of the spine begin to bread down, which may cause back pain. It is more common in older patients. 

• Intervertebral disk degeneration

In this condition, the disks — or the structures cushioning the spine between each vertebrae — begin to break down. Aside from the back, this can cause neck, arm, and leg pain. 

• Herniated disks

When the disks which cushion the vertebrae in the spine rupture or become damaged in another way, they can press on the nerves surrounding the spine, leading to extreme back pain. 

• Arthritis

When cartilage begins to break down in the vertebrae of the spine, this leads to osteoarthritis of the back. This chronic condition can cause inflammation in the lower back joints, leading to gnawing pain.

• Osteoporosis

Osteoporosis is an age-related condition that causes decreased bone density, meaning the bones become weaker. Often, osteoporosis had no symptoms. However, if it becomes advanced and affects the bones of the spine, it may lead to lower back pain. 

• Sciatica

The sciatic nerve is a nerve which extends from the buttock area down the back of the leg. If there is irritation, inflammation, or injury in the lower back which affects the sciatic nerve, it is often called sciatica.

• Kidney stones

If there is a buildup of certain minerals (e.g. calcium), in the blood, kidney stones can form in the kidneys. These stones usually cause sharp pain on one side of the lower back, and may require surgery to remove them. It’s important to seek urgent medical attention if someone is experiencing symptoms of kidney stones.

Acute lower back pain often results from a physical injury. But, there can be many other common causes of this condition. It is crucial to never self-diagnose and to consult a doctor. Treating pain in time could mean the difference between a quick recovery and chronic low back pain. 

How is acute lower back pain treated?

If acute lower back pain is from a chronic or ongoing condition (e.g. arthritis), the healthcare provider must address the underlying cause for the symptoms to resolve.

If acute lower back pain is from an injury, such as a muscle strain, it’s important to avoid further injury and consult a doctor to ensure the pain truly is from a muscle strain, not another medical condition.

When consulting a primary care doctor for acute lower back pain, they may recommend one of the following treatment options. It’s best to consult a doctor before trying any home remedies or over-the-counter medications.

1. Application of ice or heat

Applying ice or heat to the lower back can be especially helpful if a sprain or other injury caused the lower back pain. This treatment should be used as soon as possible after the injury.

Heat is very effective. It can stimulate blood circulation to the lower back, delivering oxygen and promoting healing. Heat may also remove lactic acid buildup, which can promote muscle relaxation. 

Ice application works differently. Cold temperatures constrict blood vessels, decreasing circulation to the injured site. Ice can help reduce inflammation, which may decrease recovery time. 

If patients wish to, they may use both therapies at alternating times. It’s important not to apply ice or heat for too long. In general, anything less than 20 minutes is safe and effective. 

2. Pain-relieving medication

Nonsteroidal anti-inflammatory drugs (NSAIDs) are often the first line to treat lower back pain. These include aspirin, ibuprofen, naproxen, and several other options. 

NSAIDs usually don’t have many side effects. In smaller doses, they are available over-the-counter, which means they don’t require a doctor’s prescription. A doctor may decide to prescribe a higher strength.

3. Physical therapy

Physical therapy involves specific exercises for the lower back. A patient can exercise in a physical therapist’s office or at home. 

Physical therapy may not only reduce acute pain, but it can also minimize the risk of recurrent pain, increase the time between episodes of recurrent pain, and decrease the need for other treatments. 

Physical therapists can work with each patient to develop a personalized approach to help with acute lower back pain. Working one-on-one with a physical therapist can help patients develop the best treatment plan. 

4. Muscle-relaxing medication

Doctors may prescribe muscle relaxants alone or with other pain relievers. They reduce muscle spasms, which can worsen back pain or other muscle pain. Muscle relaxants may not only reduce pain, but can make it easier for patients to move. 

Some medications in this group include cyclobenzaprine (Flexeril), tizanidine (Zanaflex), and metaxalone (Skelaxin). They are most effective in the first two weeks of acute lower back pain. Doctors prescribe these medications sparingly because they may lead to addiction or dependence.

5. Acupuncture

Acupuncture is a technique used in traditional Chinese medicine that places small needles at a superficial level at specific points on the body. 

Acupuncture may improve circulation to the lower back, which can promote healing. It may also release endorphins, the body’s natural pain-killing chemicals. Acupuncture may also improve mood, changing how someone perceives their pain severity. 

One literature review found that acupuncture can be effective for acute lower back pain that lasts more than four weeks. For patients who don’t respond to other treatments, their doctors may recommend acupuncture as another option to consider.

6. Spinal manipulation 

Spinal manipulation involves moving the joints in the back with techniques such as massage, exercise, osteopathic manipulation, and physical therapy. It can reduce inflammation, improve nerve function, and reduce joint pressure. 

Spinal manipulation may help reduce inflammation in acute lower back pain, especially if an injury caused the pain. It can also be worth considering if the patient doesn’t heal within a month. 

7. Chiropractic adjustment 

Similar to spinal manipulation, chiropractors may use their hands or a small instrument to perform adjustments by applying sudden force to the spine. Chiropractic adjustment aims to improve mobility in the spine, which may decrease lower back pain. 

Studies show chiropractic adjustment can provide modest improvements in acute lower back pain. Rarely, chiropractic adjustments may cause serious side effects. As such, it may not be the most effective treatment option. It’s important to consult a doctor before starting seeing a chiropractor. Patients who don’t respond to medication may ask their doctor about this option. 

8. Lifestyle changes 

Leading a healthy lifestyle may improve lower back pain; such as, eating a healthy diet, reducing emotional stress, and staying physically active (within limits). It’s best to consult a doctor before starting a new exercise routine.

Patients with back pain should avoid twisting, bending, or lifting heavy objects, which may make the pain worse. It may help prevent the recurrence of back pain to strengthen the muscles surrounding the lower back. A physical therapist can help design an at-home routine that accomplishes this goal. 

If acute lower back pain doesn't resolve after an initial evaluation with a doctor, it may be necessary to see a specialist. 

Is bed rest helpful for acute lower back pain?

Intuitively, it may seem like bed rest is the best solution for those with a back injury. However, it may do more harm than good. 

Prolonged bed rest may lead to muscle and bone mineral density loss. Staying in bed can cause joint stiffness, pressure ulcers, and an increased risk of blood clots. Bed rest can also reduce circulation, which may interfere with healing. 

It’s important to consult a healthcare provider and follow their recommendations about when to rest and when it’s safe to exercise again after an episode of acute lower back pain.

Takeaways

Acute lower back pain is a common condition, often injury-related. However, there are many other potential causes of acute lower back pain and it’s important to consult a doctor before starting any treatment.

If you experience lower back pain, don’t delay treatment. HealthTap can connect you with a provider over our virtual platform so you can get treated quickly. Make your appointment today.