Do I need any tests?
Your doctor will normally be able to diagnose simple low back pain or nerve root pain from the description of the pain, and by examining you. In most cases, no tests are needed. For example, x-rays or scans of the back are not helpful and do not show anything abnormal if you have simple low back pain. Also, if you have sudden onset nerve root pain, and symptoms begin to settle over the next few weeks, then no tests are needed.
Tests such as x-rays or scans may be advised if nerve root pain persists or is severe, or if another serious cause of the pain is suspected.
What are the treatments for simple low back pain?
The following advice and treatment is commonly given for a sudden 'acute' bout of simple low back pain. Most people recover quickly.
Exercise and keep going
Continue with normal activities as far as possible. This may not be possible at first if the pain is very bad. However, move around as soon as possible, and get back into normal activities as soon as you are able. As a rule, don't do anything that causes a lot of pain. However, you will have to accept some discomfort when you are trying to keep active. Setting a new goal each day may be a good idea. For example, walking around the house on one day, a walk to the shops the next, etc.
In the past, advice had been to rest until the pain eases. It is now known that this was wrong. You are likely to recover more quickly and are less likely to develop chronic (persistent) back pain if you keep active when you have back pain rather than rest a lot. Also, sleep in the most naturally comfortable position on whatever is the most comfortable surface. (Advice given in the past used to be to sleep on a firm mattress. However, there is no evidence to say that a firm mattress is better than any other type of mattress for people with low back pain.)
Medication
If you need painkillers, it is best to take them regularly. This is better than taking them 'now and again' just when the pain is very bad. If you take them regularly the pain is more likely to be eased for much of the time and enable you to exercise and keep active.
Physical treatments
Some people visit a physiotherapist, chiropractor, or osteopath for manipulation and/or other physical treatments. It is debatable whether physical treatments would help all people with acute simple low back pain. However, physical treatments provide some short-term comfort and hasten recovery in some cases.
Other treatments
Treatment may vary, and the situation should be reviewed by a doctor if the pain becomes worse, or if the pain persists beyond 4-6 weeks, or if symptoms change. Other pain relieving techniques may be tried if the pain becomes chronic (persistent).
What are the treatments for back pain other than simple back pain?
Nerve root pain
In many cases, the treatment is the same as that described above for simple low back pain. Nerve root pain often eases and goes over a few weeks. Physical treatments such as spinal manipulation may provide some short-term comfort and hasten recovery in some cases. Some people with persistent back pain that is caused by prolapsed disc pressing on a nerve may benefit from an operation.
Other causes of back pain
Treatments depend on the underlying cause. For example, pain caused by types of arthritis may be treated by various anti-arthritis medicines.
Can further bouts of back pain be prevented?
Evidence suggests that the best way to prevent bouts of low back pain is simply to keep active, and to exercise regularly. This means general fitness exercise such as walking, running, swimming etc. There is no firm evidence to say that any particular 'back strengthening' exercises are more useful than simply keeping fit and active. It is also sensible to be 'back aware'. For example, do not lift objects when you are in an awkward twisting posture.
In summary - some points to remember
