One common cause of low back pain linked to a ruptured disk is sciatica. Sciatica is caused by irritation of one of the nerves that make up the sciatic nerve. The pain from sciatica is usually described as a sharp, shooting pain that runs from the buttock down the back of the leg, sometimes as far as the foot. It is on one side and may be worse when standing, walking or sitting.

If you have symptoms of a ruptured disk, see your health care provider for an evaluation.

See your health care provider if you have back pain with these symptoms:

  • A sudden loss of bladder or bowel control, or weakness in a leg; this symptom means you need emergency care, because a ruptured disk may be causing a serious problem with nerves
  • Pain runs down your leg to your knee or ankle; this may mean a possible ruptured disk
  • Pain on one side of your back with blood in your urine and burning during urination; this may be a possible kidney stone
  • Pain after a fall or injury
  • Numbness, tingling or weakness in the legs or back
  • Difficulty urinating
  • Fever
  • Abdominal pain
  • Pain that does not improve in two to three days of self-care
  • Pain that lasts more than three weeks
  • Back pain that wakes you up at night or gets worse when you rest
  • You are older than 50 and the pain is new
  • You have had cancer or osteoporosis; you use steroids; or you abuse drugs or alcohol
  • You have unexplained weight loss

Treatment

Most acute low back pain can be treated with a pain reliever, gentle exercises, cold and hot compresses, and one to two days of bed rest (for severe pain).  Most patients with back pain recover without a loss of function. In some cases, surgery may be needed. If you try self-care of your back pain and it is not better after 72 hours, call your health care provider.

Several prescription drugs and over-the-counter (OTC) drugs are available for pain relief. Be sure to check with your health care provider before taking OTC drugs for pain relief because some are unsafe during pregnancy, may interact with other medications you take, and may cause side effects, including drowsiness, or may lead to liver damage. These are common OTC pain relievers:

  • Non-steroidal anti-inflammatory drugs, such as aspirin, naproxen and ibuprofen. These reduce stiffness, swelling and inflammation, and ease mild to moderate low back pain.
  • Creams, ointments or sprays, which are applied to the skin over the painful areas. These products can stimulate the nerve endings in the skin to provide feelings of warmth or cold to dull the sense of pain.
  • Other creams or sprays, which can reduce inflammation and stimulate blood flow. Many of these compounds contain salicylates, the same ingredient found in oral pain medications that include aspirin.

Prescription drugs that offer pain relief include anti-seizure drugs; certain antidepressants, such as amitriptyline and desipramine, which relieve pain and help with sleep; and opioids, such as codeine, oxycodone, hydrocodone and morphine, which are for short-term use to treat severe acute and chronic back pain.

Exercises prescribed by your health care provider or a physical therapist may be the most effective way to speed recovery from low back pain and help strengthen back and abdominal muscles.

You should resume your activities as soon as possible. Only people with severe back pain should rest in bed -- and then only for one or two days. Studies have shown that people who continue their activities without bed rest after an episode of low back pain recover more quickly and suffer fewer complications, such as depression, decreased muscle tone and blood clots in the legs.

Alternating ice and heat treatments may help reduce pain and inflammation. The NINDS says that you should apply a cold pack or cold compress as soon as possible after an injury. A cold compress can be a bag of ice or a bag of frozen vegetables wrapped in a towel. Apply the cold to the tender spot several times a day for up to 20 minutes at a time. After two to three days of cold treatment, apply a heating lamp or hot pad for brief periods to relax muscles and increase blood flow. A warm bath may also help relax muscles. Don't sleep on a heating pad, which can cause burns and lead to additional tissue damage.

Sleep on your side with a pillow between your knees.

If these measures don’t relieve pain, your health care provider may suggest other treatments. Medications that block the transmission of pain impulses from nerves to the brain can be injected into the painful area. Ultrasound therapy can help muscles relax. Transcutaneous electrical nerve stimulation (TENS) blocks pain signals to the brain by sending a mild electric pulse sent along nerve fibers.

Prevention

If your back pain is caused by poor physical conditioning or improper body mechanics, you can help prevent injuries by regularly doing a combination of exercises that don't jolt or strain the back, maintaining correct posture, and learning how to lift objects properly. Activities that include stretching exercises, swimming, walking and movement therapy can improve coordination and develop proper posture and muscle balance, the NINDS says. Yoga helps stretch and strengthen muscles and improve posture. Always talk to your health care provider before beginning an exercise program to make sure it is the right thing to do.

Although some people use a wide elastic belt to support back and abdominal muscles when lifting heavy objects, studies have not proved that such belts are beneficial. Don’t use these belts as a substitute for physical conditioning and proper lifting techniques.

Here are some general tips on how to maintain a healthy back and avoid causes of low back pain:

Get regular exercise

You should do some type of exercise on most days of the week. Low-impact aerobic exercises, such as speed walking, swimming or stationary bike riding for 30 to 60 minutes a day can increase muscle strength and flexibility and help maintain a healthy weight. A weightlifting program designed by a physical therapist or professional trainer can build strength and improve posture. Stretching and flexibility exercises maintain posture and prevent injury and falls.