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Compliments of American Academy Of Family Physicians

Lower Back Pain

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Back pain and discomfort with movement are common problems, often originating from overuse of the back muscles. Other causes of back pain are also described in this chart.

SYMPTOMS	DIAGNOSIS	SELF-CARE

1. Did your pain begin with a fall, a twisting injury or when you lifted an object?	Go to Question 7.**

2. Do you have numbness or pain extending down your leg?	Go to Question 4.*

3. Do you have a sudden loss of bladder or bowel control, or weakness of a leg?	You may have a slipped disk, or HERNIATED DISK.	EMERGENCY If you have lost bladder or bowel control, call your doctor or be seen in an emergency room right away.

*4. Does the pain stay in your lower back and become worse with twisting or bending?	Your pain may be from MUSCLE SPASM, a PULLED MUSCLE or a COMPRESSED NERVE.	Use heat, an anti-inflammatory medicine, and rest for up to three days. After improvement, begin abdominal muscle strengthening exercises to prevent future recurrences. If you don't improve, contact your doctor for instructions.

5. Did you have sudden and severe pain with minimal motion or a minimal fall and are you over age 60, or do you have arthritis or some changes in your spine?	You may have a COLLAPSED VERTEBRA or a crushed spine. Though it's extremely painful, it's usually not dangerous.	See your doctor.

6. Do you have pain that comes and goes in your lower spine that may have started in your teen years and was possibly aggravated by an injury?	You may have been born with a defect or crack in the spine called SPONDYLOLISTHESIS or SPONDYLOSIS.	See your doctor.

**7. Do you have a fever?	Go to Question 9.***

8. Do you have blood in your urine and one-sided back pain along with burning during urination?	Your symptoms may be from a kidney infection, PYELONEPHRITIS. KIDNEY STONES may start a kidney infection or may cause pain, blood and painful urination without a fever.	See your doctor.
	You may have a viral illness such as the FLU.	Treat yourself with analgesics, and with cold medicine. Consult your doctor if the symptoms are prolonged or severe.

***9. Do you have a blistering rash and burning pain on your back and chest?	Your pain may be from a viral infection called SHINGLES.	See your doctor.

10. Do you have stiffness in the morning or are other joints also stiff, sore, swollen or red?	ANKYLOSING SPONDYLITIS is a form of arthritis that affects the lower back. Other forms of arthritis can also cause back pain.	Treat yourself with an anti-inflammatory medicine. Heat also provides comfort. If you do not improve, or if your pain is severe, contact your doctor.

11. Are you pregnant?	PREGNANCY causes stretching of the ligaments around the uterus and pressure on the lower back.	Use mild heat to the back only. Consult your doctor if the pain continues or if fever or bleeding accompanies the pain.

12. Is the pain centered in the lower spine and do you have pain radiating down your leg to your knee or ankle?	You may have a ruptured or HERNIATED DISK.	Consult your doctor right away.

For more information, please consult your doctor. If you think the problem is serious, call right away.

This tool has been reviewed by doctors and is for general educational purposes only. It is not a substitute for medical advice. The information in this tool should not be relied upon to make decisions about your health. Always consult your family doctor with questions about your individual condition(s) and/or circumstances. Source: American Academy of Family Physicians. Family Health & Medical Guide. Dallas: Word Publishing; 1996.