Lower Back Pain

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Back pain is a common problem often caused by overusing or misusing the muscles of the back. Some causes and treatment of back pain are described in this chart.

SYMPTOMS DIAGNOSIS SELF-CARE
Begin Here

1. Did your pain begin after a fall or injury or when you lifted an object?


No

Go to Question 5.*

Yes

2. Do you have numbness or pain extending down your leg?


Yes

You may have a HERNIATED DISK.

See your doctor. Get plenty of rest and use an anti-inflammatory medicine to relieve pain. If your pain is severe, if you have lost feeling or movement, or if you have lost control of your bladder or bowels, see your doctor or go to the emergency room right away.

No

3. Are you over 60 years of age or do you have arthritis, and are you having severe pain with any movement?


Yes

You may have a FRACTURED SPINE.

EMERGENCY
Call an ambulance right away. Do not try to drive to the emergency room, and try to move as little as possible.

No

4. Do you have pain when twisting, bending or even sitting?


Yes

Your pain may be from MUSCLE SPASM, a PULLED MUSCLE or a HERNIATED DISK.

Apply heat, use an anti-inflammatory medicine and get rest. If you don't get better or if your symptoms get worse, see your doctor.

No

*5. Do you have pain that comes and goes that may have started in your teen years?


Yes

You may have SPONDYLOLISTHESIS, when one vertebra in the spine slips over another, or SPONDYLOSIS, a type of arthritis.

See your doctor. Use anti-inflammatory medicines to relieve pain.

No

6. Do you have a fever?


No

Go to Question 8.**

Yes

7. Do you have blood in your urine and one-sided back pain along with burning during urination?


Yes

You may have a kidney infection such as PYELONEPHRITIS. You may also have KIDNEY STONES, which can start a kidney infection and may cause pain, blood and painful urination without a fever.

URGENT
See your doctor right away.


No

You may have a viral illness such as the FLU.

Use analgesics such as acetaminophen to reduce fever and use over-the-counter cold medicines to treat other symptoms. See your doctor if your symptoms don't improve or if they get worse.


**8. Is your back stiff and sore in the morning and are other joints stiff, sore, swollen or red?


Yes

You may have ANKYLOSING SPONDYLITIS, a form of arthritis that affects the spine. Other forms of ARTHRITIS can also cause back pain.

Use an anti-inflammatory medicine and apply heat to the affected area. If you do not improve, or if your pain is severe or gets worse, see your doctor.

No

9. Are you pregnant?


Yes

PREGNANCY causes stretching of the ligaments around the uterus and pressure on the lower back.

Apply mild heat to the back only. See your doctor if the pain continues or if fever or bleeding accompanies the pain.

No

10. Is the pain centered in the lower spine and do you have pain down your leg?


Yes

You may have a HERNIATED DISK or SPINAL STENOSIS.

See your doctor. Get plenty of rest and use an anti-inflammatory medicine to relieve pain. If your pain is severe, if you have lost feeling or movement, or if you have lost control of your bladder or bowels, see your doctor or go to the emergency room right away.

No

For more information, please talk to your doctor. If you think the problem is serious, call your doctor right away.

This tool has been reviewed by doctors and is for general educational purposes only. It is not a substitute for medical advice. The information in this tool should not be relied upon to make decisions about your health. Always consult your family doctor with questions about your individual condition(s) and/or circumstances. Source: American Academy of Family Physicians. Family Health & Medical Guide. Dallas: Word Publishing; 1996.

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