Back pain – Managing acute lower back pain

The exact cause of your acute low back pain may be difficult to identify but in most cases it is related to things like muscle strain rather than conditions like nerve or bone damage, infection or cancer. Talk to your health professional about how to manage your low back pain.

Do you need imaging?

Your health professional might recommend an X-ray, MRI or CT scan if the test is likely to help find out what is causing your pain and how best to treat it. Imaging may be appropriate if your health professional suspects you have:

  • a broken bone in your spine
  • new back pain and a current or previous cancer diagnosis
  • other symptoms along with your acute low back pain (e.g. difficulty passing urine or weakness/numbness in your legs)
  • infection in your spine
  • ankylosing spondylitis (a form of spinal arthritis)
  • a need for imaging to evaluate or plan a surgical procedure on your spine

However, most people with acute low back pain feel better after a month – and often sooner – whether they have imaging tests done or not.
Unnecessary tests can be costly, and X-rays and CT scans involve exposure to radiation that is best avoided if the results are unlikely to help with your treatment.

What can you do?

Stay active and keep moving
Move about and stretch regularly – reduce your activities for a couple of days, but resting longer than this is not going to help you recover more quickly. Avoid staying in one position – such as sitting at your computer, watching TV or lying down – for more than 20–30 minutes at a time.
Use non-medicine treatments
Speak to your health professional about other treatments that might be right for you such as hot or cold packs, relaxation techniques and deep breathing exercises to help you to stay calm and cope with the pain or physical therapy.
Use symptom-relief medicines
Use a simple non-prescription pain reliever medicine, to reduce the pain enough to help you stay active. In most cases, regularly-taken paracetamol should be the first choice of pain reliever as it has fewer side effects than other pain relief medicines.

It’s ok to ask questions
If you have questions about your symptoms or your medicines, speak with your health professional.

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Adapted from: NPS MedicineWise (2016), Imaging tests for acute short term lower back pain, such as X-rays, MRI or CT scans. When you need them – and when you don’t. Reasonable care is taken to provide accurate information at the time of creation. This information is not intended as a substitute for medical advice and should not be exclusively relied on to manage or diagnose a medical condition. NPS MedicineWise and Choosing Wisely New Zealand do not assume any responsibility or liability arising from any error or omission or from reliance on any information in this resource.