First aid advice to assess and treat a lower back injury

Acute low back pain accounts for more than 3 percent of all emergency room visits annually in the United States. So what should you do if you tweak your back? Here is some expert advice for the first aid treatment of a lower back injury.


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  • assess the problem
  • take note of where the pain is
  • understand the conservative measures for back care
  • remember to consult a physician if…

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  • ignore systemic symptoms
  • ignore radicular pain
  • panic
  • exacerbate the pain

Nathan Wei, MD, FACP, FACR‘s recommendation to ExpertBeacon readers: Do

Do assess the problem

There’s a difference between twisting and hurting your back and falling from a 12 foot ladder. In the first example, the problem can be managed conservatively. In the latter case, it’s a good idea to get to the hospital. Acute low back pain often occurs with trivial actions such as brushing one’s teeth or taking out the trash. Even sneezing, coughing, or laughing can cause low back pain.

Do take note of where the pain is

Notice whether the pain stays in the low back or if it radiates down the leg like an electric shock. If the pain does not radiate, conservative measures are probably indicated. In the latter instance, you have sciatica and should see a physician.

Do understand the conservative measures for back care

Conservative measures consist of rest, ice packs for the first 24 hours, then switching to moist heat, placing a pillow under the knees, and taking over the counter anti-inflammatory medications. Another tip is to use a cane when walking since that takes the weight off the back.

Do remember to consult a physician if…

If the pain persists for more than 3 days or gets worse, it is advisable for you to see a physician. Most acute low back pain is due to strain, i.e. a pulled muscle and should get better with the measures mentioned above. On the other hand, if there is no improvement or there is worsening, then perhaps something else is going on.

Nathan Wei, MD, FACP, FACR‘s professional advice to ExpertBeacon readers: Don't

Do not ignore systemic symptoms

If you have fever, chills, bladder or bowel symptoms along with your low back pain, it is advisable to see a physician. Many diseases can present with low back pain and significant associated symptoms should not be ignored. Also, if there is a history of another severe illness in the past such as cancer, persistent back symptoms should not be ignored.

Do not ignore radicular pain

Radicular pain is when the pain radiates throughout an area which can indicate nerve damage. If you have an electric shock sensation radiating down your leg from your low back, you likely have a pinched nerve and should see a physician.

Do not panic

Again… most acute low back symptoms are due to muscle strain and will resolve with time and conservative measures. Don’t panic and take some time to rest.

Do not exacerbate the pain

This goes without saying, but if you are experiencing back pain of any kind, don’t lift heavy objects and try to rest as much as possible with ice packs and heat. Exacerbating your symptoms is the last thing that you want to do.


Acute low back pain is common. Most of the time it is due to muscle strain and can be managed conservatively. However, there are some cases that need to be treated with more urgency. If that is the case, consult with a physician.

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