Understanding the Difference Between Acute and Chronic Back Pain
Back pain and injuries are among the most common reasons for doctor and hospital visits. Back pain is also a common reason for missed work and lost wages. In short, it can be a real problem. Not all back pain is the same, however, and understanding the differences can play a role in how effectively you treat it.
Some back pain is considered acute, or sudden, while other back pain is considered chronic, or persistent. The distinction may seem insignificant when you’re in the middle of dealing with a bad back but understanding which category your pain falls into can affect how you treat it and whether you should seek medical care.
Understanding Acute Back Pain
Put simply, acute back pain is pain that comes on suddenly. You may experience this type of pain if you lift something heavy or twist your back suddenly. It can also be caused by minor injuries or accidents. It usually comes from a muscle strain or ligament sprain. In wealthy countries like the United States, acute low back pain is especially common. This is often attributed to our aging population and higher rates of obesity and physical inactivity1.
Acute back pain is typically sharp or sudden pain that is localized to a specific part of the back. It’s the type of pain that happens when you bend down to pick something up and feel a sudden pull in your lower back. It’s a type of back pain that may often improve with rest or basic care. Left untreated, acute back pain can easily become chronic.
Understanding Chronic Back Pain
At this point, it’s tempting to describe chronic back pain as back pain that is not acute, which is true, but as mentioned above, acute back pain can easily become chronic if left untreated. Technically, chronic pain is considered pain that lasts for over 3 months2.
Chronic back pain can result from untreated or poorly healed injuries, but it can also stem from many other causes. It can result from degenerative conditions like arthritis or degenerative disc disease. It can be caused by herniated discs or other spinal conditions. It can even be the result of poor posture or movement patterns over time.
Chronic back pain will often be experienced as dull or aching pain that persists over time. It may come and go at different times. In some cases, it may get progressively worse. In other cases, it may start to radiate into your hips or legs. Whatever the cause, it will often result in reduced flexibility and strength and have a serious impact on your ability to work and perform basic daily activities.
When Should You Be Concerned?
Often back pain will resolve with rest and time. There are situations, though, in which you will want to seek out medical attention. In these cases, you should get that medical attention as quickly as possible, before the symptoms worsen and treatment becomes more difficult. So, how do you know when your back pain is something that needs to be evaluated by a professional?
Red Flags for Acute Back Pain
- Severe pain after trauma (injury/accident)
- Sudden pain associated with numbness or weakness
- Pain that causes difficulty standing or walking
Red Flags for Chronic Back Pain
- Pain interfering with your daily life
- Pain that regularly recurs or flares up
- Pain that is spreading to your legs (possible nerve involvement)
In truth, any back pain that can be considered chronic (lasting more than 12 weeks), that is not already being treated and improving, should be considered a reason to seek medical help. Research has shown that physical therapy, including exercise therapy and manual therapy, can lead to reduced pain and improved function for chronic back pain sufferers of any age3.
How Physical Therapy Helps
Early intervention with a trained physical therapist can give you a great chance to overcome your back pain quickly, safely, and effectively. For acute back pain, a PT can use a combination of exercise and manual therapy to reduce inflammation and pain. They can help you restore mobility and get back to your daily life as quickly as possible. Importantly, they can help prevent that acute pain from progressing into chronic pain or leading to other injuries due to compensation.
For chronic back pain, a skilled PT will be able to evaluate and identify the root cause of the pain, making a targeted treatment program much more effective. They can create a personalized exercise program based on your condition and comfort level, regularly evaluate your progress and adapt that program as needed throughout your treatment. A physical therapist is uniquely qualified to help you build strength and stability, improve flexibility and function, while also providing long-term pain management strategies.
A physical therapy clinic can provide personalized, one-on-one care tailored to your specific needs and capabilities. A PT treatment program may include multiple treatment modalities, including manual therapy and customized exercise programs, or even chiropractic care, dry needling, or acupuncture. Your treatment program will not only focus on managing the pain but will also help you build strength and improve mobility, helping to prevent future injury. A physical therapist is also a great source of education. You have an opportunity to finish your physical therapy treatment program moving better, feeling better, and with greater confidence in your abilities.
Sources
- Oertel, Joachim, et al. “Acute Low Back Pain: Epidemiology, Etiology, and Prevention: WFNS Spine Committee Recommendations.” World Neurosurgery. X, vol. 22, 1 Mar. 2024, pp. 100313–100313, https://doi.org/10.1016/j.wnsx.2024.100313.
- Cleveland Clinic. “Chronic Pain.” Cleveland Clinic, 2021, my.clevelandclinic.org/health/diseases/4798-chronic-pain.
- Şahin, Nilay. “Effectiveness of Physical Therapy and Exercise on Pain and Functional Status in Patients with Chronic Low Back Pain: A Randomized-Controlled Trial.” Turkish Journal of Physical Medicine and Rehabilitation, vol. 64, no. 1, 2017, pp. 52–58, https://doi.org/10.5606/tftrd.2018.1238.
