What Should I Do

What do I do if when I first hurt my back? (Acute low back pain)

By Coralie Wales
reviewed by the Chronic Pain Switzerland National Advisory Panel

These guidelines summarise "best practice" strategies for situations where you find yourself experiencing sudden back pain. This is called "acute pain" because it has only just started.

Using best practice strategies during an acute episode of back pain can reduce the chance that it will go on and become chronic low back pain.

Many people feel quite frightened by the intensity of low back pain when it strikes unexpectedly. The good news is that for 90% of people this pain resolves within a few weeks. Acute back pain is very common and it is really important to understand what to do when it happens.

The following tips come (in part) from the New Zealand Acute Low Back Pain Guide (http://www.nzgg.org.nz/guidelines/0072/acc1038_col.pdf)

  • Get the advice of your doctor. Always voice any concerns and questions you have particularly if you are worried that it might be something serious. Doctors will routinely perform a thorough assessment including taking a full history and asking some important questions, to see that there is nothing more serious to worry about, and once this happens there are things that can be done to help reduce the pain. Your doctor should reassure you and explain what is happening. If you are not satisfied with the advice of your doctor, you may be able to seek another opinion. Please see "How to Choose your Health Care Team"
  • In the first 4-6 weeks, investigations such as X-rays and CT scans are only carried out if the doctor is concerned that there may be something more serious going on. Otherwise there is no benefit in having these done.
  • Once your doctor has confirmed that there is nothing to worry about, and you are satisfied that you are happy with his advice, DON'T worry. Worry is unhelpful. You need to find ways to maintain your activity levels.
  • Stay as active as possible without overdoing it. Lying down for longer than 2 days can be detrimental to healing. Don't spend too much time away from work if you are employed. As soon as possible, find ways of staying active with work tasks that don't flare up your pain.
  • If the doctor recommends short-term medicine, then this can be helpful. Painkillers are most commonly Paracetamol and perhaps NSAIDs (non-steroidal anti-inflammatory drugs). According to the research there is some evidence that using opiates (like Codeine or Tramal) or Diazepam (like Valium) may be harmful.
  • If your pain persists or hasn't reduced after 4-6 weeks, your doctor may refer you for a multidisciplinary assessment and treatment.