Most patients with articular symptoms will recover within several weeks of onset. (5) The majority of disc herniation will regress or reabsorb within eight weeks of onset.
In the absence of progressive neurologic deficits or other red flags, there is strong evidence to avoid CT/MRI imaging in patients with non-specific low back pain. Studies have shown that patients with no back pain often show anatomic abnormalities on imaging.
(8) Risks associated with routine imaging include unnecessary radiation exposure and patient labeling. (9) A study by Webster et al. showed that patients with occupation-related back pain who had early magnetic resonance imaging (MRI) had an eightfold increased risk of surgery.
(12) A meta-analysis by Chou et al. found no clinically significant difference in patient outcomes between those who had immediate lumbar imaging versus usual care. (7) The imaging of the lumbar spine before 6 weeks does not improve outcomes, but it does increase costs.
However, I expect like most people with low back pain you will start to feel better with the treatment.” Goers M, Thomson D, Boswell J, et al. Institute for Clinical Systems Improvement.
Diagnostic imaging for low back pain : advice for high-value health care from the American College of Physicians. Magnetic resonance imaging of the lumbar spine in people without back pain.
Acute low back pain and radiculopathy: MR imaging findings and their prognostic role and effect on outcome. Webster BS, Fuentes M. Relationship of early magnetic resonance imaging for work-related acute low back pain with disability and medical utilization outcomes.
Rapid magnetic resonance imaging vs radiographs for patients with low back pain : a randomized controlled trial. This recommendation is provided solely for informational purposes and is not intended as a substitute for consultation with a medical professional.
Patients with any specific questions about this recommendation or their individual situation should consult their physician. Radiographic imaging, like X -rays, are seldom beneficial in the evaluation of acute low back pain.
In the United States, low back pain is the second most common reason (after upper respiratory infections) for people to go to the doctor. Your low back pain can feel like a deep aching sensation that is hard to relieve, and you could worry that something is seriously wrong with your spine.
When evaluating your low back pain, your clinician will examine you to see if you have signs or symptoms of a more worrisome problem. Professional societies have recommended that imaging studies should not be obtained in the early stages of typical low back pain.
The treatment of acute low back pain is focused on relieving symptoms with strategies like gentle, targeted movements, avoidance of aggravating activities, and tailored therapies that may provide relief including: Each of these treatment modalities has been shown to provide pain relief for acute low back pain.
The reality is, except in specific circumstances, imaging of the spine with X -rays, MRIs, or other tests is typically not necessary. In fact, numerous professional societies have made specific recommendations that patients should avoid these types of imaging tests.
Of course, that doesn’t mean other potential causes of lower back pain do not warrant medical imaging immediately or at a later time. Keep in mind, the diagnostic process starts with the doctor’s evaluation of your lower back symptoms and how they relate to findings from your physical and neurological examination and medical history.
Lower back pain that radiates (spreads) downward into the buttocks and legs Abnormal reflexes in the lower body (may indicate disruption of the nerves that enable sensation and movement) Sensations of numbness, tingling and/or weakness develop Foot drop (inability to lift your foot) Dysfunction or loss of bowel and/or bladder control Therefore, people who are pregnant or have metal inside their body (e.g., spinal cord stimulator, heart pacemaker) cannot undergo MRI.
X -rays, CT scans, and MRIs are called imaging tests because they take pictures, or images, of the inside of the body. Most people with lower- back pain feel better in about a month, whether they have an imaging test.
People who get an imaging test for their back pain do not get better faster. Imaging tests can also lead to surgery and other treatments that you do not need.
Why waste money on tests when they don’t help your pain ? And if the tests lead to surgery, the costs can be much higher.
Weight loss that you cannot explain Fever over 102° F Loss of control of your bowel or bladder Loss of feeling or strength in your legs Problems with your reflexes A history of cancer These symptoms can be signs of nerve damage or a serious problem such as cancer or an infection in the spine.
Developed in cooperation with the American Academy of Family Physicians. Your doctor will examine your back and assess your ability to sit, stand, walk and lift your legs.
If there is reason to suspect that a specific condition is causing your back pain, your doctor might order one or more tests: These images alone won't show problems with your spinal cord, muscles, nerves or disks.
These scans generate images that can reveal herniated disks or problems with bones, muscles, tissue, tendons, nerves, ligaments and blood vessels. These can help determine whether you have an infection or other condition that might be causing your pain.
Electromyography (EGG) measures the electrical impulses produced by the nerves and the responses of your muscles. If home treatments aren't working after several weeks, your doctor might suggest stronger medications or other therapies.
Depending on the type of back pain you have, your doctor might recommend the following: Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin IB, others) or naproxen sodium (Alive), may help relieve back pain.
Muscle relaxants can make you dizzy and sleepy. These products deliver pain relieving substances through your skin via creams, salves, ointments or patches.
Drugs containing opioids, such as oxycodone or hydrocodone, may be used for a short time with close supervision by your doctor. Opioids don't work well for chronic pain, so your prescription will usually provide less than a week's worth of pills.
Regular use of these techniques can help keep pain from returning. Physical therapists will also provide education about how to modify your movements during an episode of back pain to avoid flaring pain symptoms while continuing to be active.
In this procedure, a fine needle is inserted through your skin, so the tip is near the area causing your pain. Radio waves are passed through the needle to damage the nearby nerves, which interferes with the delivery of pain signals to the brain.
Devices implanted under your skin can deliver electrical impulses to certain nerves to block pain signals. If you have unrelenting pain associated with radiating leg pain or progressive muscle weakness caused by nerve compression, you might benefit from surgery.
These procedures are usually reserved for pain related to structural problems, such as narrowing of the spine (spinal stenosis) or a herniated disk, that hasn't responded to other therapy. Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this disease.
A number of alternative treatments might ease symptoms of back pain. Always discuss the benefits and risks with your doctor before starting a new alternative therapy.
A chiropractor manipulates your spine to ease your pain. A practitioner of acupuncture inserts thin sterilized needles into the skin at specific points on the body.
A growing body of scientific evidence indicates acupuncture can be helpful in treating back pain. A battery-powered device placed on the skin delivers electrical impulses to the painful area.
Studies have shown mixed results as to TENS' effectiveness. If your back pain is caused by tense or overworked muscles, massage might help.
There are several types of yoga, a broad discipline that involves practicing specific postures or poses, breathing exercises, and relaxation techniques. Yoga can stretch and strengthen muscles and improve posture, although you might need to modify some poses if they aggravate your symptoms.
Take a family member or friend along, if possible, to help you remember the information you receive. Show references Back pain : In depth.
National Institute of Neurological Disorders and Stroke. Chou R, et al. Nonpharmacologic therapies for low back pain : A systematic review for an American College of Physicians clinical practice guideline.
In: Rose's Emergency Medicine: Concepts and Clinical Practice. Foster NE, et al. Prevention and treatment of low back pain : Evidence, challenges and promising directions.
Treatment of acute low back pain. Chou R. Subacute and chronic low back pain : Nonpharmacologic and pharmacologic treatment.