Acute Back Pain in Adults - A Summary

Most back pains are due to a sprain, strain, or small tear to a ligament or muscle in the lower back. The pain usually develops suddenly. This is called acute 'simple' or 'mechanical' back pain.

What are the symptoms of acute simple back pain?

Pain can range from mild to severe. The pain is typically eased by lying down flat, and made worse by movements of the back, coughing, and sneezing. Pins and needles, or numbness in part of a buttock or leg sometimes occur (but tell a doctor if these develop).

Many bouts of back pain ease quickly - within a week or so. Symptoms have either gone, or are very much eased, within four weeks in 3 out of 4 cases. In about 9 out of 10 cases the symptoms have gone or eased within six weeks. However, it is common to have further bouts of pain some time in the future. Also, it is common to have minor pains 'on and off' for quite some time after a severe bout of pain. In a minority of cases the symptoms last for several months or longer.

Back pain with any of the following symptoms may indicate a more serious problem and should be reported to a doctor.

• Weakness of leg, or of feet muscles.
• Problems with your bladder or bowels.
• Weight loss.
• Pain that develops gradually, and slowly becomes worse.

What are the treatments for acute simple back pain?

• Continue with normal activities as much as you can. This may not be possible at first if the pain is severe. However, get back into normal activities as soon as you are able. As a rule, don't do anything that causes a lot of pain. But, you will have to accept some discomfort when you are trying to keep active. In the past, advice had been to rest until the pain eases. It is now known that this was wrong. Chronic (persistent) back pain is more likely to develop if you rest rather than keep active. At bedtime, sleep in the most naturally comfortable position. Some people find a firm mattress to be the most comfortable.
• Painkillers are often helpful. It is best to take painkillers regularly for a week or so. This is better than taking them 'now and again' just when the pain is very bad. Taking them regularly may prevent pain from getting severe, and help you to exercise and keep active. If you take paracetamol at full strength four times a day, it is often sufficient to ease the pain. A doctor can prescribe something stronger if needed.
• Physical treatments. Some people visit a physiotherapist, chiropractor or osteopath for manipulation and/or other physical treatments. Whether such treatments work is debatable. However, physical treatments may quicken recovery in some people.

Treatment may vary, and you should see a doctor if:

• the pain becomes worse.
• symptoms change or new symptoms develop.
• the pain persists beyond 4-6 weeks.

© EMIS and PIP 2005   Updated: April 2005   Review Date: October 2006   CHIQ Accredited   PRODIGY Validated