If lower back pain does not start to subside within one to two weeks, or if there are troubling symptoms, medical care should be sought. A health professional will first identify a general source of pain and then determine appropriate and effective pain management methods.

In This Article:

Diagnosing Back Pain

A thorough medical history is a crucial step in diagnosing back pain.

To diagnose back pain, a doctor will begin by collecting a medical history of the patient’s current symptoms as well as lifestyle information, including sleep and habits and physical activity level.

See Getting an Accurate Back Pain Diagnosis

Questions making up a medical history typically include:

  • Where is the pain felt? Is back pain centralized in one area or does it spread?
  • Is leg pain present with the back pain? Is low back pain or leg pain more severe?
  • How long has the pain been present?
  • Does anything help alleviate low back pain?
  • Does anything make the pain worse?
  • What types of pain management have been tried so far?
  • Have there been previous episodes of lower back pain?

See Preparing to See A Doctor for Back and Neck Pain

A physical exam will also be done to assess the patient’s nerve function and mobility in the lower back and lower body. A doctor may ask the patient to hold certain positions or movements to see if they cause or worsen pain, such as raising one leg straight in front of the body, or bending forward or backward.

Sometimes diagnostic imaging tests (such as an x-ray, CT scan, or MRI) is recommended to better assess the anatomy of the patient’s spine and help guide treatment decisions.


Common Treatments for Low Back Pain

Combining information from the patient’s medical history, physical exam, and possible diagnostic tests, the healthcare provider will recommend a course of back care that fits the patient’s needs.

Non-surgical treatments for low back pain will be recommended first. Common non-surgical treatments include:

Physical therapy

Physical therapy may help strengthen back muscles and support the spine.

Physical therapy typically works to strengthen muscles and mobilize joints in order to better support the spine and minimize painful movements.

See Physical Therapy for Low Back Pain Relief

Chiropractic adjustments

Manual manipulation of the soft tissues may help relieve muscular aches and pains.

Chiropractic adjustments or manual manipulation, in which a chiropractor makes manual adjustments to the spine in order to relieve pressure and tension.

Massage therapy

Massage may help loosen tight muscles and relieve low back pain.

This therapy aims to relieve muscle tension and muscle spasms that contribute to back pain.

Prescription pain medications

Prescription medications may reduce back pain in the short term.

Prescription medications interact with the way the brain receives pain signals, effectively cutting down on back pain. Opioid Pain Medications should be taken with caution and only for acute, short-term back pain, as they are easily addictive.

Epidural steroid injections

A combination of anesthetic and/or steroid injected into the painful area of the spine may provide temporary relief.

Epidural steroid injection delivers an anesthetic and/or steroid directly to the painful area of the spine, temporarily alleviating severe back pain.

See Epidural Steroid Injections

Spinal surgery may be recommended if the patient’s pain fails to respond to nonsurgical treatments, such as those listed above. Spinal surgery is usually the patient’s decision, which will be guided by a number of factors such as the intensity of back pain, how much the patient’s everyday life would be affected, and the type of surgery that can be done given the patient’s condition.


When Back Pain Indicates A Medical Emergency

Certain symptoms may indicate a medical emergency. While these conditions are rare, it is important to seek immediate medical attention should any of the following symptoms accompany back pain:

  • severe abdominal pain
  • unexplained fever
  • bowel or bladder incontinence
  • loss of/altered sensation in the groin and/or legs

See When Back Pain May Be a Medical Emergency

Additionally, if back pain begins after an injury, immediate medical care is warranted to check for damage to the spine.

Dr. Nayan Patel is a physiatrist at the Texas Back Institute, where he has been using non-surgical techniques to treat patients with chronic back and neck pain for 20 years. Dr. Patel is the Director of Conservative Care at Texas Back Institute and has served on the Board of Managers of the Presbyterian Plano Center for Diagnostics and Surgery.