Acute Low Back Pain

Symptoms, Causes and Treatment

Acute Low Back Pain

Acute low back pain is the first stage of a back injury. But don't worry -- while it's certainly true that chronic pain can develop out of an episode of acute low back pain, with early treatment, it is possible to avoid a long term problem. Here are the basics about symptoms, causes and treatment of acute low back pain.

What is Acute Low Back Pain?

A physiotherapist holding spine model
BSIP/UIG/Universal Images Group/Getty Images

Acute low back pain means relatively short-term pain, stiffness and/or muscle tension anywhere in along the back, starting below the ribs and extending to just underneath the buttocks. The length of time you've had the pain distinguishes it from chronic back pain. Experts differ on its duration, but it's usually no more than 12 weeks. Like all types of back pain, symptoms tend to be subjective and often cannot easily be verified by exams or tests. Treatment is mainly focused on the pain itself.

Acute low back pain is one of the top reasons why people seek medical attention, yet only a small percentage people with it do.

The good news is that non-specific low back pain often resolves on its own after a few weeks.  On the other hand, getting the right type and amount of early treatment may help you stop your acute low back pain from developing into a chronic condition.

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Are You At Risk for Acute Low Back Pain?

Working from the core out
Adductor muscles help you balance on a rock, a BOSU ball and while standing. Tassii/Getty Images

Adults between the ages of 35 and 55 are the most at risk for acute low back pain. Spending a lot of time in static positions - such as when you work all day at a computer -  is a big contributor to an increased risk of this type of pain.

Other risk factors include heavy physical work, bending and/or twisting frequently (which can contribute to a disc herniation), and lifting.

In 2015, the American Academy of Orthopedic Surgeons reviewed 26 million patient records (of which 1.2 million had back pain) in an effort to identify risk factors for combined acute and chronic low back pain.  They found that 19.3% of  patients who had been diagnosed with depression reported lower back pain, as did 16.75% of obese patients (i.e., those with a body mass index at or above 30.)

The study found that people with nicotine dependence and those who abused alcohol reported higher levels of back pain, as well.

Causes of Acute Low Back Pain

CT scans may pose a cancer risk due to high doses of radiation.
CT scans may pose a cancer risk due to high doses of radiation.. snowleopard1

Most acute low back pain cases are diagnosed as "non-specific," meaning the doctor doesn't know what causes it. As a patient, this may seem frustrating to you, but keep in mind that treatment, and in many cases simply waiting it out, can be instrumental in pain relief.

Unless your doctor picks up on signs of a complicated health condition (called red flags), diagnostic imaging tests are generally not necessary. If the pain persists despite treatment, at that point, such tests may be helpful.

Sadly, even though clinical guidelines recommend only judicious use of imaging tests for back pain diagnosis, many doctors routinely overuse them, even in mild cases of acute low back pain.  In a 2009 article entitled "Overtreating Chronic Back Pain: Time to Back Off?"  which was published in the Journal of the American Board of Family Medicine, Dr. Rick Deyo, et. al, comment that the use of lumbar magnetic resonance imaging (MRI) increased in the Medicare population by 307% in the 12 year period from 1994 to 2006.

The researchers add that up to 2/3 of these test may have been inappropriately given.

Sources of acute low back pain may include disc problems, vertebral fractures, muscle strain and/or ligament sprain.

Getting Your Acute Low Back Pain Checked by a Doctor

Back Doctor
Back Doctor. Tomas Rodriguez / Getty Images

Even with the industry related problems around overuse of diagnostic imaging tests for people with first time or mild pain, getting medical attention for your acute back pain can be an important step in your healing.  The reason is that  early treatment may help you avoid a long-term back problem.

When you go to the doctor for your back pain, she will conduct a medical interview (called a history) and a physical exam. The information she gathers at this appointment will help her diagnose your pain by placing you into one of three general categories: non-specific low back pain, nerve-related pain or other causes and red flags. Your treatment and any required testing will likely be determined based on your category.

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Acute Low Back Pain Treatment

Physical therapy treatment
Physical therapy treatment. sylv1rob1

Treatment for acute low back pain generally starts with pain medication and advice. Your doctor will likely tell you to remain active but modify it downward to accommodate your pain.

Over-the-counter (OTC) or prescription pain medications are usually tried first, and your doctor will instruct you on how to take care of your back. If this first line of defense doesn’t work, she may prescribe physical therapy, chiropractic care or other treatment.

Similar to diagnostic imaging, (discussed above) prescription pain medication, in particular, opioids which are associated with the risk of becoming addicted, have the potential for overuse and misuse.  The Journal of the American Board of Family Medicine article mentioned earlier concluded that there was a 423% increase in spending on opioids for back pain.

But a 2016 study published in the Journal of the American Medical Association found that two non-drug treatments - mindfulness-based stress reduction and cognitive behavior therapy  - provided greater relief and improved functionality when compared to "usual care" at the doctor's.  


Most primary doctors have limited training on back pain, and as such, you may get a hasty referral to a specialist, or find your care to be unsatisfactory. In this case, don’t hesitate to ask your physician for a prescription for physical therapy or suggestions on alternative medicine and exercise.

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How to Keep Acute Pain from Developing into Chronic Back Pain

For people with chronic back pain, depression can rear its ugly head.
For people with chronic back pain, depression can rear its ugly head. So what can you do about the depression that comes with your chronic back or neck pain?. Sanjay Pindiyath

If you’re not careful, acute back pain may lead to a disability. There are two different ways this could happen. First, if you don’t control inflammation and subsequent scar tissue, it can decrease your flexibility which may lead to more injury.  Scar tissue can also lead to muscle spasm and trigger points.

Second, with time, your body may undergo permanent changes that make your nervous system erroneously amplify and distort sensations, which is a chronic pain condition.

Early treatment and regular exercise are two of the best ways to keep acute back pain from developing into a chronic pain condition.

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Preventing Acute Low Back Pain

Hip bridge for back pain relief and prevention
Hip bridge for back pain relief and prevention. Dorling Kindersley / Getty Images

As the saying goes, the best treatment is prevention.

To prevent acute low back pain, keep your muscles flexible and strong, with exercise that incorporate good alignment. Activities such as yoga, Pilates and other core strengthening systems may help you work your entire body, giving you the opportunity to train your muscles to support your daily activities.

And body mechanics may go a long way toward preventing acute low back pain. For example, when you lift heavy objects, bend from the hips and knees and not the back. This is protective for your spine because your legs and hips are bigger and stronger relative to your spine.  Employing good body mechanics also helps keep your spine in a well-aligned position as you add additional load during lifting.


Cherkin, D.C. (2016) ‘Mindfulness-Based stress reduction vs cognitive behavioral therapy’, JAMA, 315(12), pp. 1240–1249. doi: 10.1001/jama.2016.2323.

Deyo, R. Overtreating chronic back pain: time to back off? J Am Board Fam Med. Jan-Feb 2009. Accessed: June 2016.

Press Release. Low back pain risk factors identified. American Academy of Orthopaedic Surgeons website. March 2015.

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