Do I need an x-ray, CT, or MRI of my back?

Most patients do not need images (x-rays, etc) taken of their back. These images are not often helpful for patients with acute low back pain. They can lead to unneeded or even harmful procedures. They are also costly. X-rays and CT scans expose you to radiation. Your prescriber will ask you questions and do an exam to decide if you need images.

What can I do to help the pain?

  • Remain active. Keep doing your normal activities to the extent possible.
  • If you sit at work, stand up and move around for a few minutes every half hour.
  • Apply a heating pad or heated blanket, or cold pack to your back for only 15 to 20 minutes at a time. Use what works for you. You can alternate heat and cold. Do not apply heat or cold directly to your skin. Be extra careful if you have decreased feeling on your skin and can’t tell if something is too hot or too cold.

Do I need pain medicine?

Pain meds can help reduce pain so you can keep active and do your normal activities. Narcotic pain meds have not been shown to work better than acetaminophen (Tylenol), ibuprofen (Motrin), or naproxen (Aleve) for low back pain. Narcotic pain meds can make you sleepy or groggy. This can keep you from staying active and slow your recovery. You may not need any pain medicine at all. If you do, your prescriber or pharmacist can fill in the dose and instructions here:

Do I need a muscle relaxer?

Muscle relaxers have not been shown to work better than acetaminophen (Tylenol), ibuprofen (Motrin), or naproxen (Aleve) for low back pain. Muscle relaxers can make you sleepy or groggy. This can prevent you from remaining active and slow your recovery. But a short course may be prescribed if a pain med is not enough. Your prescriber or pharmacist can fill in the dose and instructions for your muscle relaxer here:

Do I need physical therapy?

Your prescriber might recommend chiropractic, massage, yoga, physical therapy, or other therapy, especially if your back pain doesn’t get better within a few weeks.

How long will my back pain last?

Most patients are pain-free in two to four weeks.

When should I call my prescriber?

Seek medical care if your symptoms get worse, new symptoms appear, or you are not improving.

What can I do to prevent back pain in the future?

  • Ask your prescriber what kind of exercise would be best for you.
  • Maintain a healthy weight.
  • Maintain good posture when sitting or standing.
  • Lift with your legs, not your back.

This post may not cover all possible information. It does not replace the need for professional medical care. Always follow the instructions from your health care provider.

Pharmacist’s Letter 2013; 29(12):291207