Chronic Back Pain

Chronic back pain is back pain that lasts 3 months or longer. This may include pain that has not been controlled or does not improve with treatment. Your back pain may cause weakness or pain that spreads to your arms or legs.

What causes or increases my risk for chronic back pain?

Conditions that affect the spine, joints, or muscles can cause back pain. These may include arthritis, spinal stenosis (narrowing of the spinal column), muscle tension, or breakdown of the spinal discs. The following increase your risk for back pain:

  • Aging
  • Lack of regular physical activity
  • Repeated bending, lifting, or twisting, or lifting heavy items
  • Obesity or pregnancy
  • Injury from a fall or accident
  • Driving, sitting, or standing for long periods
  • Bad posture while sitting or standing

How is chronic back pain diagnosed?

Your healthcare provider will ask if you have any medical conditions. He or she may ask if you have a history of back pain and how it started. He or she may watch you stand and walk, and check your range of motion. Show him or her where you feel pain and what makes it better or worse. Describe the pain, how bad it is, and how long it lasts. Tell your provider if your pain worsens at night or when you lie on your back.

How is chronic back pain treated?

  • NSAIDs help decrease swelling and pain or fever. This medicine is available with or without a doctor's order. NSAIDs can cause stomach bleeding or kidney problems in certain people. If you take blood thinner medicine, always ask your healthcare provider if NSAIDs are safe for you. Always read the medicine label and follow directions.
  • Acetaminophen decreases pain and fever. It is available without a doctor's order. Ask how much to take and how often to take it. Follow directions. Read the labels of all other medicines you are using to see if they also contain acetaminophen, or ask your doctor or pharmacist. Acetaminophen can cause liver damage if not taken correctly. Do not use more than 4 grams (4,000 milligrams) total of acetaminophen in one day.
  • Prescription pain medicine called narcotics or opioids may be given for certain types of chronic pain. Ask your healthcare provider how to take this medicine safely.
  • Muscle relaxers help decrease pain and muscle spasms.
  • Steroids decrease inflammation that causes pain.
  • Anesthetic medicines may be injected in or around a nerve to block pain signals from the nerves.
  • Antidepressants may be used to help decrease or prevent the symptoms of depression or anxiety. They are also used to treat nerve pain.

How can I manage my symptoms?

  • Apply ice for 15 to 20 minutes every hour, or as directed. Use an ice pack, or put crushed ice in a plastic bag. Cover it with a towel before you apply it to your skin. Ice decreases pain and helps prevent tissue damage.
  • Apply heat for 20 to 30 minutes every 2 hours, or as directed. Heat helps decrease pain and muscle spasms.
  • Use massage to loosen tense muscles. Massage may relieve back pain caused by tight muscles. Regular massages may help prevent this kind of back pain.
  • Ask about acupuncture for pain relief. Back pain is sometimes relieved with acupuncture. Talk to your healthcare provider before you get this treatment to make sure it is safe for you.

What else can I do to relieve or prevent back pain?

  • Manage stress. Stress can cause back pain or make it worse. Some ways to reduce stress are listening to music, meditating, or using aromatherapy. It may help to talk with a therapist about anything that is causing you stress. Your healthcare provider can give you more information.
  • Stay active as much as you can without causing more pain. Ask your healthcare provider what exercises are right for you. Do not sit or lie down for long periods. This could make your back pain worse. Yoga or similar gentle movements may help relieve pain and tension in your back. Go slowly and do not strain your back as you do any movement.
  • Be careful when you lift heavy objects. Do not lift anything heavy until your pain is gone. Never strain your back when you lift a heavy item. If possible, ask someone to help you.
  • Go to physical therapy as directed. A physical therapist can teach you exercises to help improve movement and strength, and to decrease pain.

When should I call my doctor?

  • You have severe pain.
  • You have new numbness, tingling, or weakness, especially in your lower back, legs, arms, or genital area.
  • You lose control of your bladder or bowel movements.
  • You have a fever or sudden weight loss.
  • You have new or worse pain.
  • You have questions or concerns about your condition or care.