Low back pain

Low back pain is pain that can occur anywhere below the ribs and above the legs. It is very common. Almost everyone has it at one time or another.

Low back pain can be:

• Acute. This is new pain that can last a few days to a few weeks—at the most a few months.
• Chronic. This pain can last for more than a few months. Sometimes it can last for years.

Back pain can come on quickly or over time. You may feel:

• Pain in your hips or buttock.
• Leg pain, numbness, tingling, or weakness. When a nerve gets squeezed—such as from a disc problem or arthritis—you may have symptoms in your leg or foot. You can even have leg symptoms from a back problem without having any pain in your back.
• Pain that's sharp or dull, sometimes with stiffness or muscle spasms. It may be in one small area or over a broad area. But even bad pain doesn't mean that it's caused by something serious.

A physical exam is the main way to diagnose low back pain. Your doctor may examine your back, check your nerves by testing your reflexes, and make sure that your muscles are strong. Your doctor also will ask questions about your back and overall health.

Most people don't need any tests right away. Tests often don't show the reason for your pain.

If your pain lasts more than 6 weeks or you have symptoms that your doctor is more concerned about, then your doctor may order tests. These may include an X-ray, a CT scan, or an MRI. Sometimes other tests such as a bone scan or nerve conduction test may be done.

Most low back pain improves with self-care. This includes ice or heat and light activity such as walking. Use over-the-counter pain medicine as needed.

For severe symptoms or pain that continues after 2 weeks of self-care, see your doctor. You may benefit from other treatment, such as stronger medicine, exercises, or manual therapy.

There are a number of other treatments for back pain. You may need to try more than one to see what works best for you. Common treatments include acupuncture, massage, and yoga.

For chronic back pain, one type of treatment by itself may not help. The best plan is often a mix of treatments.

For the first day or two of pain, take it easy. But as soon as you can, ease back into your normal activities. Lying down for too long can make back pain worse. Sitting can make it worse too.

Here are some tips that can help.

• When you're resting, change positions every 30 minutes.
• Try to avoid too much bending, heavy lifting, or reaching.
• When you sit, place a small pillow or a rolled-up towel in the curve of your back for support.
• If you stand still for a period of time, try putting one foot up on a stool or changing positions every few minutes.
• Get gentle exercise, such as walking. If you can, walk for 10 to 20 minutes at a time every 2 to 3 hours.
• Try heat or ice to ease back pain. Use what works best for you.
• Use over-the-counter pain medicine as needed. Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen seem to work best for low back pain. But if you can't take NSAIDs, you can try acetaminophen.