ACUTE LOW BACK PAIN

What to do, when to get help, and how to stay safe

Guidance from international pain medicine leaders

30

Pain Specialists

14

Countries

3

Review Rounds

40+

Care Areas

10

Key Tips

1

1

Talk With Your Care Team

Your pain is real and should be taken seriously
Ask what is causing concern, what is expected, and what to do next
Work with your clinician on a plan that fits your goals and safety needs

Start with listening, education, and a shared plan

2

2

Start Self-Care Right Away

Keep moving gently and stay as active as you safely can
Use heat and light stretching if they feel helpful
Avoid bed rest unless your clinician tells you otherwise
Sleep, hydration, and regular meals can support recovery

Most acute low back pain improves with time and movement

3

3

If You Are Not Improving, Add Support

Physical therapy, spinal manipulation, or acupuncture may help some people
Ask whether anti-inflammatory medicine is safe for you
Muscle relaxants may be considered for selected situations
Non-drug options can often be combined for better support

Use options that help you move and function

4

4

Know When to Follow Up

Check back in if pain is getting worse or not improving
Ask what changes would mean you need urgent care
Your clinician may look for less common causes if symptoms persist
Your plan should change based on how you are doing

Do not feel stuck with a plan that is not working

5

5

Leg Pain or Sciatica: Ask What Fits

If pain travels down the leg from an irritated nerve, a local injection may help
Steroid pills are not clearly helpful for routine acute low back pain
Injection relief is usually temporary and should be part of a broader plan

Discuss benefits, risks, and alternatives with your clinician

6

6

Warning Signs: Get Help Now

Urgent: trouble controlling your bladder or bowels
Urgent: new or worsening numbness, weakness, or numbness around the groin/saddle area
Tell your clinician: cancer history, infection risk, major trauma, or possible fracture
If a warning sign appears, do not wait for it to pass

Safety signs matter more than pain intensity alone

7

7

Scans Are Not Always Needed

Imaging may be needed if a warning sign is present
Imaging may be needed with cancer history or concern for infection or fracture
Routine X-rays or MRI usually do not improve uncomplicated back pain
Most acute low back pain is not caused by a serious disease

Your exam and history guide whether imaging is useful

8

8

Opioids Are Not the First Choice

Start with non-opioid options whenever possible
Opioids often do not improve function in acute low back pain
Early unnecessary opioid use can create avoidable risk
Ask what safer options can help you move and sleep

The goal is safer pain relief and better function

9

9

If Opioids Are Used, Use Them Carefully

Use only as prescribed and only for a short time
Review side effects, driving safety, storage, and disposal
Recheck whether the medicine is helping function, not just pain
Stop or avoid opioids when safer options are working

10

10

Use a Whole-Person Recovery Plan

Stress, sleep, mood, and activity can affect recovery
Use movement, education, coping tools, and medicine when needed
Your preferences and safety should guide choices
Escalate care only when symptoms or risks make it appropriate