What a pain in the back!

Good morning NIDPC family,
Continuing our discussion for common musculoskeletal injuries, we will talk about acute low back pain and when we need imaging. This is one of the most common reason people seek medical care, and while I hope you never have a back spasm, it is good to be prepared. I will review emergency signs for acute back pain, initial therapy for acute back pain, and how to rehab and maintain your back to decrease these injuries.


If you have any of the following symptoms, there could be significant infection, trauma or injury to your spinal column – you likely need to be evaluated in an Emergency Room.
1) If your back pain started after an injury – depending on age, even minimal car accidents or falls can be significant.
2) If you CANNOT feel around your groin or bottom
3) If you CANNOT control going to the restroom – Bowel movements or urine
4) If you have a history of cancer with new onset of back pain
5) If you have fevers, chills, night sweats or unexplained weight loss with severe back pain
6) If you have been using IV drug use
7) If you have been on certain medications like steroids for prolonged periods of time

Now there are many other reasons that may need to have imaging performed, and this is a good discussion to have with your physician.

How not to be a slug and get back out there

For most back pain that is related to spasm or slipped disc, the initial treatment is the same.
1) Decrease activity but DO NOT BE A SLUG
2) Start OTC pain medications to decrease pain (Naproxyn OR Ibuprofen)
3) Ice or Heat can help decrease the swelling or pain
4) Start stretching slowly to increase your range of motion
5) Consider acupuncture or alpha stim

Rehabilitation for back pain:

Once we are out of the acute spasm, it is time to work on prevention. Many times back pain originates from a spasm in the paraspinal muscles after moving in a way that risked the back. By reinforcing the core strength of your back, you are often able to decrease the recurrence of injuries. The Human Performance Center at the Uniformed Services University has provided these exercises to help you perform these exercises at home.

Short of the red flags above, a MRI will only be approved if you have participated in formal physical therapy. A home exercise program “might” qualify, but depending on what we think the etiology of the pain is will dictate our recommendations in clinic.

Many of us struggle with low back pain and this is an important topic. If you would like to learn more about controlling your back pain or are suffering from acute back pain, let’s work together to control your back pain. Please call us at the clinic to discuss with Dr. Silakoski or myself.

M. Ryan Odom, MD
North Idaho Direct Primary Care


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