Health Guide — Low Back Pain (Mechanical, Adult)
Low Back Pain — Fast Relief Without the Pitfalls
Most acute low back pain improves in 2–6 weeks. Keep moving, use heat, and consider short courses of NSAIDs if safe. Avoid prolonged bed rest, repeated imaging, or early opioid use. Seek urgent care for saddle anesthesia, new bladder/bowel dysfunction, progressive leg weakness, fever with severe pain, or significant trauma.
What typically causes it
Most flares are mechanical (muscle/ligament strain, facet irritation, disc‑related pain) and self‑limited. Sciatica indicates nerve root irritation, not always a herniation that requires surgery.
What helps (evidence‑based)
Relative activity: gentle walking, frequent change of position; short rest only for severe spikes.
Heat therapy: 15–20 minutes several times/day.
Analgesics: short NSAID course if no GI/renal/bleeding risks; acetaminophen if NSAIDs are contraindicated. Avoid mixing multiple NSAIDs.
Muscle relaxants: consider a brief (≤5 days) non‑benzodiazepine option at bedtime for spasm; expect sedation.
Sleep & ergonomics: knee pillow in side‑lying; desk setup with lumbar support; standing breaks every 30–45 minutes.
A simple home program (print‑ready)
Mobility: pelvic tilts, single‑knee‑to‑chest, lumbar rotations (10 reps each, 2–3x/day).
Directional preference: try gentle press‑ups (extension) if sitting worsens pain; choose knee‑to‑chest (flexion) if standing worsens pain.
Core control: abdominal bracing, bird‑dogs, modified side planks (5–10 breaths each).
Progression: increase walk time by 5 minutes every other day as pain allows.
When imaging is useful (and when it isn’t)
Immediate imaging if red flags exist (cancer, infection risk, major trauma, severe/progressive neurologic deficits).
Consider MRI if radicular pain or neuro deficits persist >6 weeks despite active care.
Avoid routine x‑rays/MRIs in the first weeks of uncomplicated pain — they seldom change management and can prompt unnecessary interventions.
Red flags — stop and seek care now
Saddle anesthesia; new bladder/bowel retention or incontinence.
Progressive leg weakness, fever with spine pain, night pain unrelieved by rest.
History of cancer, IV drug use, chronic steroid use, or significant trauma.
Medication cautions
Opioids and gabapentinoids are not first‑line for mechanical pain; risks often outweigh benefits.
Steroid dose packs generally do not help for uncomplicated mechanical low back pain.
If using NSAIDs: take with food, avoid duplicates, and limit duration.
How TeleDirectMD helps
We triage red flags, craft a personalized home plan, and discuss short, non‑controlled medication options when appropriate. We’ll outline follow‑up timing and when to escalate to in‑person evaluation.
Internal links
Gout flare treatment → /treatments/gout-online-treatment
Anxiety/Depression refills → /health-guides/anxiety-depression-antidepressant-refills-online
Smoking cessation maintenance → /treatments/smoking-cessation-refills-online
Book your $49 MD video visit to build a move‑more, hurt‑less plan that fits your day.
