When to seek medical advice

Most back pain disappears with home treatment and self-care. Although it may take several weeks before back pain completely disappears, you should feel some improvement within the first 72 hours of self-care. If not, see your doctor.

In rare cases, back pain can signal a serious medical problem. See a doctor immediately if your back pain:

• Feels constant or intense, especially at night

• Spreads down one or both legs

• Causes weakness, numbness or tingling in one or both legs

• Causes new bowel or bladder problems

• Is associated with abdominal pain or pulsation (throbbing)

• Is the result of a fall or blow to your back

• Is accompanied by unexplained weight loss

• Abdominal pain

Also see your doctor if you're older than age 50 or have a history of back pain or cancer.

Screening and diagnosis

Your doctor will examine your back and assess your ability to sit, stand, walk and lift your legs. He or she may also test your reflexes with a rubber hammer. These assessments help determine where the pain is, what degree of motion you have without pain and whether you have muscle spasms.

In most cases, diagnostic tests aren't necessary to confirm the cause of your pain. However, if your doctor suspects a tumor, fracture, infection or other disease, you may undergo one or more procedures:

• X-ray. These images show the alignment of your bones and whether you have degenerative joint disease or broken bones. X-ray images won't directly show problems with your spinal cord, muscles, fibrous tissues (fascia), nerves or disks.

• Magnetic resonance imaging (MRI) or computerized tomography (CT) scans. These scans can generate images that may reveal herniated disks or problems with bones, muscles, tissue, tendons, nerves, ligaments and blood vessels.

• Bone scan. In rare cases, your doctor may use a bone scan to look for bone tumors or compression fractures caused by osteoporosis. In this procedure, you'll receive an injection of a small amount of a radioactive substance (tracer) into one of your veins. The substance collects in your bones and allows your doctor to detect bone problems using a special camera.

• Electomyography (EMG). This test measures the electrical impulses produced by the nerves and the responses of your muscles. Studies of your nerve conduction pathways can confirm nerve compression caused by herniated disks or narrowing of your spinal canal (spinal stenosis).

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