Acute low back pain

Acute low back pain (LBP) is defined as low back pain present for up to six weeks. It may be experienced as aching, burning, stabbing, sharp or dull, well-defined, or vague. The intensity may range from mild to severe and may fluctuate. The pain may radiate into one or both buttocks or even into the thigh/hip area.


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How long will an episode of low back pain last? The good news is that even if the exact source of pain is not determined, usually the acute pain subsides spontaneously over time. The originally irritated tissue heals. Fifty percent of episodes nearly completely resolve within two weeks, and 80% by six weeks. Unfortunately, the duration and severity of a single episode cannot be predicted based on the onset, location of pain, or even the initial severity. Excruciating initial pain may resolve within several days while moderate or mild symptoms may persist for weeks. However, up to 30% of individuals will experience recurrent pain or develop persistent pain in the future. Is this pain dangerous? The seriousness of LBP is relative. The symptoms of acute LBP are usually benign and self-limiting. Even a ruptured disc has a chance of improving without surgery. Rarely, however, LBP is caused by a more serious process such as a fracture, infection or cancer.


How should acute LBP be managed? Some of the best advice for treatment for acute LBP is to continue to remain active as tolerated. Continuing to perform everyday activities may seem counterintuitive, and the natural inclination may be to stay in bed or freeze to guard and avoid activity. Yet, activity keeps blood and nutrients flowing to the affected area, inhibiting inflammation and reducing muscular tension. Many individuals with LBP find that they can perform their usual, but more controlled cardiovascular activities, such as walking, in spite of the pain and often feel better after the activity. More vigorous or uncontrolled activities such as weight lifting or competitive or contact sports are inadvisable while pain is severe. There is no reason to completely avoid stretching muscles and tissues in the legs and back during an acute episode, but stretching should not cause more severe pain. Local application of heat or ice can temporarily reduce pain and heat may facilitate stretching, but does not necessarily speed long term recovery. Medication: Both paracetamol and nonsteroidal anti-inflammatory drugs (NSAIDs) are analgesics (pain relievers) which are known to provide the effective reduction in of acute LBP.

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