If you have ever had pain in your lower back, you are not alone. Thousands of South Carolinians see doctors for this kind of pain each year. And nationally, 1 in 4 working adults experience low back pain, according to the National Institute for Occupational Safety and Health*.

You should know what kind of care to seek when you have pain in the lower back. 

There are two kinds of low back pain: acute and chronic. Most cases are acute pain. This means the pain starts suddenly as a result of a specific event. Chronic pain is continual and lasts for a long time. 

How You Can Treat the Pain 

Many doctors recommend treating acute low back pain at home first. Apply heat or ice, stretch gently, and walk to ease the pain. 

Some people can get pain relief from over-the-counter, anti-inflammatory medicines like ibuprofen (Advil, Motrin IB or generic) or naproxen (Aleve and generic). Follow the dosages on the package. 

Visit Your Doctor

If self-care does not help, visit a primary care physician. You can find a network doctor in My Health Toolkit^®. 

“You do not necessarily need to go to the emergency room or a specialist to start,” says Dr. Lloyd Kapp, a medical director with BlueChoice^® HealthPlan of South Carolina. “Your primary care doctor can handle this and assess if further evaluation is needed.” 

Your Medical History Is Important

Your doctor will conduct a physical exam and ask for a complete medical history. The doctor will check reflexes, strengths and weaknesses to help determine the cause of the pain. Be sure to provide a full and complete medical history, according to Kapp. 

“Most of the information a doctor needs to determine treatment for acute back pain can be learned from a thorough medical history and physical examination,” Kapp says. 

Imaging Tests May Not Be Necessary

Our most current data (from 2017) tells us doctors ordered more than 100,000 unnecessary imaging tests in an outpatient setting for back pain. They ordered more than 14,000 unnecessary tests in the emergency room. These tests did not inform treatment and exposed people to potential risks. 

This is why medical organizations advise against imaging tests such as X-rays, CT scans and MRIs for acute back pain within the first six weeks. 

Imaging tests for lower back pain usually do not help and can sometimes cause harm. X-rays and CT scans use radiation. Over time, radiation can be harmful. It is best to avoid it when possible. 

Tests Can Be Expensive

These tests can lead to incidental findings and more tests you don’t need. 

Those tests and procedures can come with high costs. Imaging tests can cost hundreds or thousands of dollars. If those tests lead to surgery, the cost could get higher. 

When Do You Need Imaging Tests?

If there are certain red flags, you may need imaging, Kapp says. The doctor will look for those red flags. They may include things such as numbness or weakness in the legs. 

Other symptoms may mean you need imaging tests right away. Discuss those with your doctor. Other symptoms to look out for include: 

• Weight loss you cannot explain.
• Fever over 102 degrees.
• Loss of control of your bowels or bladder.
• Loss of feeling or strength in your legs.
• Problems with your reflexes.
• A history of cancer.

Know What To Ask 

Before you see a doctor, know what questions to ask. 

If the doctor recommends imaging tests before six weeks, ask why.

Other questions to consider include: 

• What are you looking for? 
• What will you do with that information? 
• How will you use the results to change the treatment? 
• What happens if I don’t do anything? 
• How much does it cost?
• Will my insurance cover it? 

Read more about how to always stay knowledgeable on our website. 

BlueChoice^® HealthPlan is an independent licensee of the Blue Cross Blue Shield Association. 

*This link leads to a third-party website. That party is solely responsible for the content and privacy policy of its site.

(Updated May 2023)

Nov. 14, 2019