# *** [Acute/Chronic] Back Pain 2/2 ***
MSK - lumbar strain, muscle spasm, degenerative disc or facet, herniated disc, sciatica, spinal stenosis, spondylolisthesis, compression fracture, rib fracture
Neoplastic - spinal mets, primary tumor, intraabdominal malignancy
Infectious - osteomyelitis, spinal epidural abscess, psoas abscess, pyelo, cholecystitis/cholangitis
Vascular - hematoma, infarction, aortic aneurysm/dissection/rupture, RP hematoma
Inflammatory - ankylosing spondylitis, reactive arthrtitis
Other- pancreatitis, nephrolithiasis, PUD
Template coming soon
Acute Back Pain
Based on your history and physical exam, we believe that your back pain is likely due to ***.
Most acute back pain resolved within 4-6 weeks with supportive care.
While your body heals, we recommend continuing activity as able, and treating with *** (NSAID, muscle relaxant). Other things that can help with pain include heat/ice packs, stretches, and massage.
Some stretches can be found at this link: https://www.healthline.com/health/lower-back-stretches
You *** [do/do not] currently need to have any labs or imaging done.
Please let us know how you are doing in 2-3 weeks. If things are not improving, we may trial other medications, or consider a consult to physical therapy.
Acute back pain in the outpatient setting is most commonly due to MSK etiologies and often resolves within 4-6 weeks with supportive care. Prioritize NSAIDs and muscle relaxants along with other modalities like heat/ice, massage, and stretching. Physical therapy has been validated in sciatica, but not other etiologies of back pain. Labs and imaging should only be pursued if there are red flags including focal neuro deficits, infection, cancer, immunocompromise, weight loss, IVDU, or long-term steroid use. Otherwise, imaging can be pursued after 4-6 weeks and should start with an X-Ray followed by a lumbar MRI. Many findings of degeneration are not actually linked to the pain the patient is experiencing. Make sure the pain is not actually flank or abdominal pain.