Treatment options include physical therapy, back exercises, weight reduction, steroid injections (epidural steroids), nonsteroidal anti-inflammatory medications, rehabilitation and limited activity. All of these treatment options are aimed at relieving the inflammation in the back and irritation of nerve roots. Physicians usually recommend four to six weeks of conservative therapy before considering surgery.
If low back pain occurs after a recent injury — such as a car accident, a fall or sports injury — you should call your primary-care physician immediately. If there are any neurological symptoms, you should seek medical care immediately. If there are no neurological problems (i.e. numbness, weakness, bowel and bladder dysfunction), you may benefit by beginning conservative treatment at home for two to three days. You may take anti-inflammatory medications such as aspirin or ibuprofen and restrict strenuous activities for a few days.
If low back pain gets worse or does not improve after two to three days of home treatment, contact a primary-care physician. The physician can evaluate you and perform a neurological exam in the office to determine which nerve root is being irritated, as well as rule out other serious medical conditions. If there are clear signs that the nerve root is being compressed, your physician can prescribe medications to relieve the pain, swelling and irritation; he or she also may recommend limitation of activities. If these treatment options do not provide relief within two weeks, it may be time to consider other diagnostic studies and possibly surgery.