Oh! My lumbago!
Seriously, back pain is actually no joke. Most cases of acute low back pain start suddenly and can be debilitating, significantly impacting one’s life and the activities of daily living. The range of pain can vary from mild discomfort to agonizing. Nevertheless, most cases are benign and last less than 6 weeks. Low back pain is quite common, and most cases get better on their own.
Let’s discuss benign back pain, then potentially serious back pain.
Cause of Low Back Pain
The common causes of low back pain include muscle or ligament strains and sprains, often from poor posture and lifting heavy objects or sudden, abrupt movements, including twisting of the back. Being physically active appears to be protective.
To that point, when you have low back pain, you should stay active, but within limits. Don’t lie in bed–that doesn’t help and will likely make things worse. Acutely, you can apply cold packs for 20 minutes every two to four hours for the first two to three days, then alternate with heat. If you find heat works better, then stick with that. Cold therapy has little long-term benefit but does reduce the pain. Heating pads are a great tool for back care. As hard as it may be, back stretches are essential for feeling better. Strengthening your core will stabilize the back, and a physical therapist may be helpful in getting you back to normal.
It is important to exercise your abs as a strong belly helps maintain a strong back. Keep good posture! This can be tough, sitting at a desk with a computer screen running your life, but if you can get a standing computer platform, you will be better off. As for medications, you can use ibuprofen (or another anti-inflammatory medication, usually called NSAIDS, non-steroidal anti-inflammatory drugs) or acetaminophen. Narcotic medications do not benefit you and are to be avoided. A short course of muscle relaxants (I emphasize “short”), which are prescription medications, can be beneficial in some cases.
In a small proportion of back pain cases, there may be a serious cause, and it is important to know when to seek medical attention. These can range from infectious causes to tumors. Back pain that also has an associated fever or weakness, numbness or tingling in the legs, or loss of urine or bowel control calls for a visit to the emergency department. If the back pain is from an accident or trauma, get help. Back pain with weight loss, history of cancer, and intravenous drug use also warrants prompt attention, as does pain that fails to improve after a few weeks. These associated signs and symptoms are known as “red flags.”
X-rays are rarely helpful in cases of back pain. MRIs are helpful in cases where the pain fails to improve or if you have red flags.
Avoid back pain by staying active, lifting from your legs, not bending over with your back, and maintaining good posture. We at The Village Doctor are happy to help you avoid back pain, but if we need to help you get through it, we are here to assist. Concierge Medicine can customize your back pain plan. It is best to avoid trouble rather than fix a problem, but we are here for both.
Wishing you health and safety,
Dr. Spira
Alan Spira, MD, & DTM&H, December 2025
Read Also: Get Your Teenager (and Yourself) to Bed!
Take the first step towards improving your child’s health with pediatric integrative medicine. Call The Village Doctor at (650) 851-4747 or Contact us to learn more about the practice.
