BACK PAIN Symptom Definition Upper, mid or lower back pain that occurs mainly in the midline. Not due to a known major (e.g. auto accident, fall) back injury General Information Lower back pain is the cause of countless visits to doctors' offices and emergency rooms. It is the second most common cause of lost workdays, after cold and flu symptoms. Over 80% of people experience lower back pain at some point in their lives. In most cases, the cause of lower back pain is not serious, and the pain usually subsides within 4-6 weeks, without special treatment. See More Appropriate Topic (instead of this one) If CHEST PAIN, if the pain is in the part of the upper back that overlies the rib cage rather than the spine. WHEN TO CALL YOUR DOCTOR FOR BACK PAIN Call 911 Now (you may need an ambulance) If Passed out (fainted) Very weak (can't stand) Call Your Doctor Now (night or day) If You feel weak or very sick Severe pain Visible sweat on face, or sweat is dripping down your face Associated abdominal pain Weakness of a leg or foot Tingling or numbness in the legs or feet Numbness in groin or rectal area Unable to urinate and your bladder feels very full Blood in urine Fever and pain over lower ribs of back (flank) Vomiting and pain over lower ribs of back Pain or burning with urination and pain over lower ribs of back Pain goes into groin or scrotum Pregnant and pain is not relieved with rest You have a history of cancer, HIV, or intravenous drug abuse Call Your Doctor Within 24 Hours (between 9 am and 4 pm) If: You think you need to be seen You have a history of cancer, HIV, or intravenous drug abuse Fever Rash or blisters in same area as pain Call Your Doctor During Weekday Office Hours If You have other questions or concerns Back pain lasts more than 2 weeks Back pain is a recurrent, ongoing problem Over 50 years old and you have not experienced similar back pain previously Back pain lasts more than 3 days and it interferes with normal activities or awakens you from sleep Pain radiates (shoots, spreads) into the thigh or down a leg Self Care at Home If Mild back pain and you don't think you need to be seen Back to Top HOME CARE ADVICE FOR MILD BACK PAIN Reassurance: Heavy lifting or excessive twisting can cause lower back pain. With treatment, the pain usually goes away in 1 to 2 weeks. Local Cold Or Heat: During the first 2 days after a mild injury, apply a cold pack or ice bag (wrapped in a moist towel) to the sore muscles for 20 minutes four times a day. Wrap the cold pack in a towel to prevent frostbite. After 2 days, apply a heating pad or hot water bottle to the most painful area for 20 minutes whenever the pain flares up. Wrap hot water bottles or heating pads in a towel to avoid burns. Sleep: Sleep on your side with a pillow between your knees. If you sleep on your back, place a pillow under your knees to reduce stress on your lower back. Avoid sleeping on your abdomen. The mattress should be firm or reinforced with a board. Avoid waterbeds. Activity: Continue ordinary activities as much as your pain permits. Continued activity is more healing for the back than rest. Avoid any activities that significantly increase the pain. Avoid heavy lifting, twisting, and strenuous exercise until completely well. (Note: complete bed rest is unnecessary.) Pain Medication: For pain relief, take acetaminophen every 4-6 hours (Adults 650 mg) OR ibuprofen every 6-8 hours (Adults 400 mg). Do not take ibuprofen if you have stomach problem, kidney disease, are pregnant, or have been told by your doctor to avoid this type of anti-inflammatory drug. Do not take ibuprofen for more than 7 days without consulting your doctor. Do not take acetaminophen if you have liver disease. Read the package instructions thoroughly on all medications that you take. Prevention: The only way to prevent future backaches is to keep your back muscles in excellent physical condition. A sedentary lifestyle (lack of exercise) is a risk factor for developing back pain. Walking, stationary biking, and swimming provide good aerobic conditioning as well as exercise for your back. Being overweight puts more weight on the spine and thus increases the risk of back pain. If you are overweight, work with your doctor to develop a weight-loss program. Good Body Mechanics: Lifting: Stand close to the object to be lifted. Keep your back straight and lift by bending your legs. Ask for lifting help if needed. Sleeping: Sleep on a firm mattress. Sitting: Avoid sitting for long periods of time without a break. Avoid slouching. Place a pillow or towel behind your lower back for support. Posture: Maintain good posture. Strengthening Exercises: During the first couple days after an injury, strengthening exercises should be avoided. The following exercises can help strengthen the back. Perform the following exercises 3-10 times each day, for 5-10 seconds each time. Bent knee sit-ups: Lay on back, curl forward lifting shoulders about 6 inches off the floor. Leg lifts: lay on back, lift foot 6 inches off floor (one leg at a time). Pelvic tilt: lay on back with knees bent, push lower back against floor. Chest lift: lie face down on ground, place arms by your sides, lift shoulders off the floor. Call Your Doctor If: Numbness or weakness occur Bowel/bladder problems occur Pain persists for more than 2 weeks You become worse or develop any of the "Call Your Doctor" symptoms. Back to Top Disclaimer: This information is not intended be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information. Adult HouseCalls Online. Copyright © 2000-2005 David Thompson, M.D. FACEP Reviewed 10/1/2005 Revised 10/18/2005 See Other Topics: Chest Pain View Index of Topics