Your healthcare provider will assess your ability to sit, stand, walk, and lift your legs, as well as ask you to rate your pain on a scale of zero to 10 and discuss how it affects your daily activities, in order to determine the source and severity of your back pain. These evaluations can also help eliminate more serious causes of back pain, such as muscle spasms.

To pinpoint the cause of the pain, one or more of the following tests may be used:

  • X-ray: This imaging method can show broken bones or arthritis, but it cannot detect problems with nerves, muscles, disks, or the spinal cord.
  • MRI or CT scan: These scans create detailed images that can reveal issues with bones, muscles, tendons, nerves, ligaments, blood vessels, or herniated disks.
  • Blood tests: These tests can determine if an infection or other medical condition is causing the pain.
  • Nerve studies: Electromyography (EMG) can measure the electrical signals generated by nerves and how muscles respond to them, which can help diagnose nerve pressure caused by herniated disks or spinal stenosis.

Treatment:

For people under the age of 60, the majority of back pain can be resolved within a month of self-care at home, but some people may experience pain for several months. Pain relief medication and heat therapy can be effective treatments, and bed rest is not recommended.

It is important to maintain your regular activities, including light exercise like walking, and to avoid any activity that worsens the pain. Do not let the fear of pain prevent you from engaging in activity. If home treatments do not provide relief after a few weeks, your healthcare provider may suggest stronger medications or alternative therapies.

The choice of medication for back pain depends on the type of pain being experienced. Possible medications include:

  • Pain relievers: Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen sodium can be effective, but should only be taken as directed and not overused to avoid serious side effects. Prescription NSAIDs may be recommended if over-the-counter pain relievers do not help.
  • Muscle relaxants: If pain relievers do not improve mild to moderate back pain, a muscle relaxant may be prescribed, but may cause dizziness and drowsiness.
  • Topical pain relievers: Creams, salves, ointments, and patches that deliver pain relief through the skin can be effective.
  • Narcotics: Opioid drugs like oxycodone or hydrocodone may be used for a short time under close medical supervision.
  • Antidepressants: Certain types of antidepressants, such as duloxetine and tricyclic antidepressants like amitriptyline, have been shown to relieve chronic back pain.

Physical therapy can be used to treat back pain by teaching exercises that increase flexibility, strengthen back and abdominal muscles, and improve posture. These techniques can help prevent pain from returning, and physical therapists can also provide education on modifying movements during a back pain episode to remain active without exacerbating symptoms.

Other procedures that may be used to treat back pain include:

  • Cortisone injections: If other treatments are ineffective at relieving pain that radiates down the leg, an injection of cortisone and a numbing medication around the spinal cord and nerve roots may provide temporary relief by reducing inflammation.
  • Radiofrequency ablation: This procedure involves inserting a needle near the source of pain and using radio waves to damage nearby nerves, interfering with pain signals to the brain.
  • Implanted nerve stimulators: Devices implanted under the skin can deliver electrical impulses to certain nerves, blocking pain signals.
  • Surgery: In some cases, surgery to create more space within the spine can be helpful for people experiencing increasing muscle weakness or back pain that radiates down a leg. These issues may be related to herniated disks or other conditions that narrow the openings within the spine.