Harvard Men's Health Watch

Low back pain: Treatment and prevention

About three of every four men have endured a bout of low back pain, and many have had repeated episodes. The pain may begin gradually or suddenly; it may be mild or severe. In most cases, doctors cannot pinpoint the cause of the pain, and in most cases x-rays and blood tests are useless. In fact, even advanced imaging techniques such as MRIs and CTs are not recommended for typical patients.

Most people with low back pain can handle the problem themselves, sometimes with the aid of a phone call or visit to their doctor and the short-term use of simple medications. But there are exceptions; the list below details situations that call for prompt medical attention.

Warning signs: When to worry about your back

  • First episode before age 20 or after 55

  • Recent major trauma, including motor vehicle accidents, falls, and severe sports injuries

  • Radiation of pain down a leg, particularly if accompanied by:

  • Numbness or loss of sensation

  • Weakness or loss of muscular strength

  • Impaired bowel or bladder control

  • Constant pain that is not affected by motion

  • Pain in the upper back or chest

  • Pain that increases at night or when lying down

  • Unexplained weight loss of 10 pounds or more

  • Unexplained fever

  • A previous diagnosis of cancer

  • Use of corticosteroids or other immunosuppressive drugs

  • History of drug abuse

  • History of a major chronic medical illness

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