Back Pain - What you need to know
Depending on the level of low-back pain you have and how often you have it, your treatment options may vary greatly. We hope this information about back pain helps you be and feel healthier and get the most out of the health care services you receive.
Evaluate Your Back Pain - when you can expect to improve
There are many different causes of low-back pain. It can be very painful, often making it difficult to conduct daily activities. Frequently, a specific cause is never found. The good news is in most cases, low-back pain resolves with time. Below are some guidelines to help you make informed choices about your care.
Please note: the information below is not intended as medical advice for your particular situation. Call your primary care provider for medical advice or if you have any questions.
- Evaluate symptoms
- Begin self-care
- Contact your primary provider
- Medical evaluation
- Consider non-surgical options
- Consider surgical options
Talk with a Nurse
Registered nurses are available to help Medica members answer their health questions, learn self-care tips or get information that can help them choose appropriate care for their situation.
Call the Medica CallLink® Nurseline at
1-800-962-9497.
If this is an emergency, please call 911.
Are warning signs present?
For the vast majority of individuals who experience an acute episode of low-back pain, 90 percent recover within six weeks.
However, if you're experiencing back pain along with one or more of the following 'red flag' symptoms or conditions, contact your primary care doctor immediately to rule out any serious causes:
- sudden loss of bladder or bowel control
- "saddle" numbness (numbness in the area where you sit)
- weakness in either leg or pain that extends below the knee
- fever
- unrelenting pain at night or when resting
- serious injury or accident
- unexplained weight loss
- history of cancer, osteoporosis or other serious medical condition
Treatment Options
In most situations, back pain goes away in a few weeks after using self-care or conservative treatment measures. If those measures are unsuccessful, your doctor will recommend more aggressive treatment. Below is a summary of the stages of back pain treatment.
Early treatment
As long as you don't have any red flag conditions with your back pain, there are some simple steps you can take to help your back heal:
- Apply ice to ease pain and swelling. If ice doesn't seem to help, you can try alternating between heat and ice or try heat alone.
- Take an over-the-counter pain reliever or anti-inflammatory medicine.
- Limit bed rest to no more than two days.
- Carefully resume your normal activities as you are able, but avoid activities that strain your back.
Most people feel better after using these self-care measures for a few weeks. If you are not improving, contact your primary care doctor to see if an office visit is needed. Your doctor may provide you with exercises to help strengthen your back, and may prescribe medication to help alleviate your pain. He or she may also refer you to a specialist for further evaluation.
Conservative treatment
If early treatment measures are unsuccessful in addressing your back pain, your primary care doctor may refer you to a:
- physical therapist
- physiatrist (also called a rehabilitative medicine physician), or
- chiropractor
Each of these providers uses conservative, noninvasive measures to relieve your back pain.
For people with chronic back pain (pain lasting longer than 6 weeks), studies suggest that the most effective treatment is a therapy program that focuses on improving spine fitness and strength. Providers that specialize in this type of active rehabilitation use intensive exercise, specially designed machines and other methods to reduce pain and restore function.
If your chronic pain doesn't respond to these treatments, your doctor may recommend injections. While invasive, injections are still considered a conservative treatment. There are various types of injections, with some having limits on how often and how many times they can be used. As with any procedure, there are potential risks associated with injections. Additionally, studies show mixed results on whether certain injections are effective. Discuss specific concerns with your doctor.
Aggressive treatment
If early treatment and conservative treatment measures are unsuccessful, your doctor may refer you to an orthopedist or a neurosurgeon to be evaluated as a possible surgery candidate. Generally, surgery is helpful for only a small percentage of people with low-back pain. Some conditions that can be treated with surgery include:
- a herniated disk that causes severe, disabling sciatica (pain, weakness, numbness or tingling in the leg)
- spinal stenosis (a narrowing of the spine that puts pressure on your spinal cord or nerves)
- spinal fracture due to an injury
- spinal infection
- spinal tumor
After most surgeries, a comprehensive rehabilitation program is necessary.
Want to know more?
You can learn more about back pain treatment options on MedlinePlus, or, if you are a Medica member, you may also have access to information on mymedica.com in the Health and Wellness Center.
Please note the information shown here is not intended as medical advice for your particular situation. Call your primary care provider for medical advice or if you have any questions.
Back Fact:
Self-care or office visit? Sometimes it's hard to know whether you should see your doctor or stick with self-care. If you're a Medica member, check the back of your medical ID card to see if you have access to Medica CallLink®. This 24-hour service will connect you with an experienced registered nurse who can help you determine your next step.Provider cost and quality information
To see cost and quality information for providers who treat back pain, select a link from the list below.
Facilities with low-back programs
These providers offer a specific, focused program for treating chronic low-back pain. The programs use exercise and other methods to reduce pain and restore function.
Chiropractors
Health care professionals who treat back problems using techniques such as manipulation and adjustment of the spine; massage; application of heat or cold; and electrical stimulation.
Neurosurgeons
Medical doctors with a surgical specialty in treating diseases and disorders of the brain, spinal cord and other parts of the nervous system.
Orthopedists
Medical doctors with a surgical specialty who use surgical and non-surgical methods to treat and correct deformities, diseases and injuries to the skeletal system and surrounding muscles.
Physical therapists
Health care professionals who use non-surgical treatments and exercises that reduce pain, restore function and prevent disabilities.
Primary care providers
Medical doctors who serve as the patient's primary contact for health care services. Primary care doctors generally focus on prevention and health maintenance, as well as treatment of common acute and chronic ailments. These physicians may specialize in family medicine, internal medicine or pediatrics.
Rehabilitative medicine physicians/Physiatrists
Medical doctors who diagnose and treat patients with physical disabilities using non-surgical methods. Rehabilitative medicine physicians (also called physiatrists) may also lead a team of other medical professionals who carry out the treatment plan the physiatrist develops. Pain management is often an important part of their role.
View a list of clinics with rehabilitative medicine physicians/ physiatrists on staff
Radiologists
Medical doctors who use imaging methodologies to diagnose and manage patients and provide therapeutic options.
View more information about radiologists' role in treating back pain
Back Fact:
85 percent of the time, the specific cause of low-back pain cannot be determined.
Back care basics
There are several things you can do to prevent a back injury:
- Maintain a healthy weight. Because being overweight can make back pain worse, it's best to shed unnecessary pounds. Check your body mass index (a ratio that estimates your body fat content based on your height and weight) using this online calculator to see if you're at a healthy weight.
- Keep stress under control. Tension and stress can make your back pain feel worse. Do your body a favor and use meditation, progressive muscle relaxation, massage, yoga or other relaxation techniques to help manage stress and improve your overall well-being.
- Exercise. In addition to helping you lose weight (or maintain a healthy weight) and combating stress, exercise builds strength and endurance. With your doctor's approval, do exercises that strengthen your core (back and abdominal) muscles. Low-impact activities such as walking and swimming are good for your back, too.
- Use proper lifting techniques. Ask for help lifting objects that are too heavy or awkward to lift alone. When lifting, bend at the knees, keep your back straight and keep the object close to your body. Be careful not to twist your body while lifting.
- Know how to sit and stand properly. If you sit at a desk for long periods of time, choose a chair that provides good support for your lower back (the chair should help you maintain your back's natural S-shaped curve). If you need extra support, place a small pillow or rolled-up towel behind your lower back. When standing for long periods of time, place one foot on a low stool to relieve pressure on your lower back. Alternate feet every five to 15 minutes. Whether standing or sitting, take frequent breaks to stretch.
- Practice good posture. Stand or sit up straight, keeping your ears, shoulders and hips in line. This will maintain the natural S-shaped curve of your back, reducing stress on your muscles, joints and ligaments. Choosing the right shoes and strengthening your abdominal muscles will also help you improve your posture.
- Sleep right. In most cases, it's best to sleep on your side with your knees bent and slightly drawn up toward your chest. Try putting a pillow between your knees for added comfort. Sleep on a medium-firm mattress. If your mattress isn't firm enough, try placing a plywood board underneath for added support. If your mattress is too firm, try adding a padded mattress topper to allow the bed to better contour to your body.
Find other tips for preventing a back injury on MedlinePlus.
Please note the information shown here is not intended as medical advice for your particular situation. Call your primary care provider for medical advice or if you have any questions.
Back Fact:
Smoking interferes with circulation, which can rob your spinal disks of oxygen-rich blood, speeding disk degeneration. If you smoke, do your back a favor and quit! If you're a Medica member, call the Customer Service number on the back of your medical ID card to see if you have access to resources that can help you kick the habit.
Additional resources
Medline Plus
Find a variety of back pain tools, information and resources on Medline Plus, a service of the U.S. National Library of Medicine and the National Institutes of Health.
Resources for Medica members:
- Medica CallLink® nurse line - Talk about your health concerns with a registered nurse at Medica CallLink. If your employer has chosen to offer access to this service, you will find the CallLink phone number on the back of your Medica ID card.
- My Health Rewards by Medica® - Use this online tool to help you reach your health goals at your own speed. Go slow. Go fast. Take tiny steps. Make a giant leap. Commit totally. Play around. Dip your toe. Jump all in. Push yourself. Give yourself a breather. Sooner or later, you’ll get there. Whether it’s pounds or cholesterol points you want to drop, this engaging online tool can help. Try it out for yourself—go to mymedica.com and click on the health and wellness tab.
Additional Web resources:
American Academy of Orthopaedic Surgeons/American Association of Orthopaedic Surgeons
American Academy of Physical Medicine and Rehabilitation
American Association of Neurological Surgeons
Back Fact:
90 percent of people with low-back pain feel better within six weeks.
