Understanding and Managing Acute Low Back Pain
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Acute low back pain can feel daunting and even frightening, especially for first-timers. Many people worry about serious damage to their lumbar spine when they experience excruciating pain. For those who also feel radiating sensations in the buttocks, groin, or even down to the heels, it's common to self-diagnose as having "sciatica."
However, diagnosing sciatica is more stringent than many people realise. For example, it typically involves specific signs such as lower-limb weakness and reduced deep tendon reflexes. This means that a quick Google search may not provide an accurate diagnosis.
What is acute vs. chronic low back pain?
Acute low back pain typically refers to pain occurring along the lumbar spine or, in some cases, the pelvic girdle within the first 72 hours of onset. Common symptoms include a sharp or burning sensation on one or both sides of the lower back, muscle spasms, and a significantly reduced range of motion, such as difficulty bending over. Some individuals even report "collapsing" episodes, where standing up from a chair or bed feels nearly impossible and may cause them to fall.
In contrast, chronic low back pain refers to pain that persists for more than 12 weeks. Patients in this category may have experienced several severe acute episodes, but the pain continues or is repeatedly triggered over a period of three months.
What should I do if I have acute low back pain?
First and foremost, stay calm. The lumbar spine is one of the most robust structures in the human body.
There are many possible causes of acute back pain, but the most common ones seen by physiotherapists include heavy lifting (especially with bending or twisting), muscle spasms, or flare-ups of pre-existing chronic conditions.
The immediate response should be to eliminate these triggers. This may mean avoiding lifting heavy objects, using cryotherapy, or doing gentle muscle-relaxing exercises (see below). The only approach not supported by clinical guidelines is prolonged bed rest. Even if you're in significant pain, you're encouraged to go for gentle walks and frequently change positions.
Do I need to see someone for treatment?
It depends. Seeing a practitioner within the first 24 hours may not be ideal, as some hands-on treatments could actually aggravate the pain.
Instead, try staying active, using heat packs, and taking over-the-counter pain relief or anti-inflammatory medications. Monitor how your symptoms evolve over the first 1 to 2 days. If the pain doesn't improve or gets worse, it's time to see a physiotherapist for both hands-on treatment and a personalised management plan.
How can physiotherapy help?
Physiotherapists are skilled at identifying the root cause of your back pain and creating an individualised recovery plan. This might include manual therapy, exercises to restore functional movement, and strategies to prevent recurrence.
When should I see my GP?
If your back pain includes strong, electric-like sensations in both legs or causes severe night pain that keeps you awake, it’s a good idea to see your GP for further assessment and possibly a prescription for anti-inflammatory medication.
If you experience symptoms such as numbness around the pelvic floor, urinary retention, or incontinence, go to the nearest Emergency Department immediately or call 000 for emergency assistance.
Take-home message
Stay calm
Remain relatively active and avoid prolonged bed rest
Use pain relief if necessary (e.g. Panadol or Ibuprofen)
Apply heat packs to the affected area
Try simple muscle-relaxing exercises. One option is to lean on a table, supporting yourself with your elbows. Take five deep breaths, and repeat this every 1 to 2 hours.
See a physiotherapist if your symptoms don't improve within 48 hours
Are you suffering from acute low back pain and seeking some relief? Book an appointment with one of our physiotherapists today.
Author: Jack Qin, Balance North Preston Physiotherapist