Duration Health — Field Guide: Back

Back Pain

Introduction

Back pain has many causes, ranging from minor muscle strain to severe spinal injury or infection. For most people with back pain, it is due to a benign cause; however, it is important to know the warning signs to look out for so you can be alerted to the more serious causes of back pain. Usually, acute back pain is caused my muscle sprain or injury due to some sort of overuse or strain to the back. Sometimes back pain can be associated with sharp/electric pain that radiates down one or both legs, indicating that there may be a pinched nerve in the back, called sciatica. Chronic back pain may be due to arthritis or problems with the discs in the back.

When back pain is associated with any of the following signs or symptoms, it indicates a more serious cause that necessitates immediate medical care: muscle weakness in the arms or legs; bowel or bladder incontinence or dysfunction; loss of sensation in the arms, legs or groin area; fevers/chills; sudden onset of severe pain; or traumatic injury to the back.

Treatment

For most people with acute back pain due to muscle strain/sprain, the pain will usually resolve in 1-2 weeks and using pain relievers such as ibuprofen or acetaminophen will help relieve symptoms. For other, more serious causes of back pain, seek immediate medical care because these conditions can rapidly progress to loss of neurologic function and death.

Pediatrics

When To Worry

Seek immediate medical care if you have any of the following:

  • back pain that starts after trauma, such as a direct blow to the back, a fall, or other trauma to the back
  • fevers or chills associated with back pain
  • weakness anywhere in the body, including in the arms or legs
  • any urinary symptoms, including pain with urination, urinating on yourself, or unable to urinate
  • any bowel symptoms, including loss of control of bowel movements
  • decreased sensation anywhere in the body, including in the arms, legs or groin area
  • sudden onset of severe back pain
  • back pain with chest pain or shortness of breath
  • if you use IV drugs

Quick Guide

If you have

  • lower back pain that occurred after overuse injury or muscle strain
  • NO warning signs listed above

You may have

muscular-related back pain

Consider

ibuprofen (generic for Motrin®) 600 mg every 6 hours as needed for pain

OR

acetaminophen (generic for Tylenol®) 1000 mg every 6-8 hours as needed for pain (do not exceed 3000 mg per day)

OR

methyl salicylate-menthol (generic for IcyHot®) 1 application to affected area every 4-6 hours as needed

OR

Pediatrics

For children age 17 and under

ibuprofen 10 mg/kg every 6 hours as needed; maximum 400 mg per dose

acetaminophen 15 mg/kg every 6 hours as needed; maximum 500 mg per dose

methyl salicylate-menthol (generic for IcyHot®) cannot be used in children

See also: Pediatrics

If you have

  • lower back pain with sharp or electric pain that shoots down the backs of legs
  • NO warning signs listed above

You may have

sciatica

Consider

ibuprofen (generic for Motrin®) 600 mg every 6 hours as needed for pain

OR

acetaminophen (generic for Tylenol®) 1000 mg every 6-8 hours as needed for pain (do not exceed 3000 mg per day)

If you have

  • back pain that starts after trauma, such as a direct blow to the back, a fall, or other trauma to the back
  • fevers or chills associated with back pain
  • weakness anywhere in the body, including in the arms or legs
  • any urinary symptoms, including pain with urination, urinating on yourself, or unable to urinate
  • any bowel symptoms, including loss of control of bowel movements
  • decreased sensation anywhere in the body, including in the arms, legs or groin area
  • sudden onset of severe back pain
  • back pain with chest pain or shortness of breath
  • if you use IV drugs

You may have

kidney stone, kidney infection (pyelonephritis), spinal cord compression, spine fracture or spinal abscess/infection, or other medical emergency

You should

seek emergency medical care

Reference

Cyclobenzaprine (generic for Flexeril) is a muscle relaxer. It is used to treat painful muscle spasm.

Prescription only

GeneralMedication

Methyl salicylate-menthol (generic for IcyHot) treats muscle aches.

GeneralMedication

Ibuprofen (generic for Motrin, generic for Advil) is a pain reliever and the most commonly used non-steroidal anti-inflammatory drug (NSAID). Ibuprofen is used to treat pain.

GeneralMedication

Acetaminophen (generic for Tylenol) is a pain reliever and fever reducer. Acetaminophen is used to treat pain.

GeneralMedication

Ibuprofen (generic for Motrin, generic for Advil) is a pain reliever and the most commonly used non-steroidal anti-inflammatory drug (NSAID). Ibuprofen is used to treat pain.

GeneralMedication

Acetaminophen (generic for Tylenol) is a pain reliever and fever reducer. Acetaminophen is used to treat pain.

GeneralMedication

Acetaminophen (generic for Tylenol) is a pain reliever and fever reducer. Acetaminophen is used to treat pain.

GeneralMedication

Ibuprofen (generic for Motrin, generic for Advil) is a pain reliever and the most commonly used non-steroidal anti-inflammatory drug (NSAID). Ibuprofen is used to treat pain.

GeneralMedication

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