Back pain is one of the leading reasons for people to miss work and seek help from a doctor or physiotherapist. Acute back pain is a symptom with many potential causes or contributing factors, including musculoskeletal, psychological and environmental factors. In most cases, back pain is of musculoskeletal origin and may involve any of the structures in the lower back region, such as:

  • Muscle
  • Joint
  • Ligament
  • Disc
  • Nerve

In most cases of acute lower back pain, it will be one of these structures involved and the prognosis for recovery is good. However, there are some more serious conditions which must be ruled out.

If you experience any of these symptoms alongside your back pain, seek urgent medical review:

  • Altered sensation in the saddle region
  • Bladder or bowel dysfunction
  • Widespread pins & needles, numbness or weakness in both legs
  • Severe, unremitting night time pain
  • Sudden, unexplained weight loss

Prognosis

In most cases of acute low back pain, symptoms will resolve within a few days to a couple of weeks. However, this may vary depending on symptom severity, the causes/contributing factors as well as personal characteristics.

How much should I move?

The simple answer is… as much as you can (within your limits of pain)! It is a common misbelief that bed rest is the best medicine in an episode of acute lower back pain. This is something that was often prescribed in the past, but it is now known to have negative consequences. With complete rest, joints in your back become stiff and muscles around your back become rigid, tight and irritated, all of which will prolong your recovery! By continuing to move within tolerable ranges, you will limit the secondary effect on your muscles and joints and promote a faster recovery. To return to your daily routine as quickly as possible, the best thing to do is practice your daily routine!

Should I get a scan?

Whilst scans can be beneficial in determining a diagnosis, they aren’t always necessary. This is because many of the findings that a scan may pick up (such as a disk bulge, disk protrusion or disk degeneration) are likely part of normal aging and not associated with pain. In fact, disk degeneration may be reported in up to 30% of 20-year-olds who exhibit no symptoms at all, and this percentage increases with age. However, there are some cases where it may be useful to get a scan. If your physiotherapist believes a scan would be beneficial, they can refer immediately for a scan or refer you back to your GP to have the scans organised.

Treatments

In an acute episode of lower back pain, treatments are generally focused on pain relief and increasing levels of movement. This will typically involve activity modification, massage or trigger point release of tight or irritated muscles, gentle movements of the spine, and some exercises to promote movement. In the early stages of your recovery, your physiotherapist may also administer tape to limit certain provocative movements. Other strategies which can help to relieve pain and restore movement are by use of heat, acupuncture and pain medications (consult your doctor of pharmacist for advice on medication). Treatment is always targeted to the individual presentation and will vary from person to person.