In an interview with the Health Channel, Dr. Jonathan Gottlieb, an Orthopedic Surgeon with Baptist Health South Florida, talks about the difference between acute and chronic back pain, and how both can be treated.

Dr. Gottlieb defines acute back pain as back pain that has been present for six weeks or less, while chronic back pain refers to more than 12 weeks of back pain. That middle ground between acute and chronic is called subacute back pain and it typically encompasses pain that lasts from a month and a half to three months. 

While treatment plans for subacute and chronic back pain can be similar, Dr. Gottlieb explains that he usually treats acute back pain very differently. “If you have someone that’s had back pain for about a month and a half, they haven’t done anything, if it’s not gotten worse, I would generally start them off with conservative measures,” Dr. Gottlieb offers. If there is no reason for him to believe that a more complicated issue is causing the pain, then he says he usually would initiate a workup instead of waiting the four to six weeks to do imaging. 

Dr. Gottlieb warns though that, oftentimes, an acute pain can turn into chronic pain if not treated mindfully. Dr. Gottlieb explains that, “It’s related to how we tend to deal with pain. If something hurts, we tend to not move, we tend to try to protect that area.” The doctor continues, “What happens, very often with the back, is that you have a sprain or a strain and it hurts to move, so we move less. Then we get stiffer and then we try to move and that hurts, so we become stiffer. Eventually people will come in and say, ‘My gosh, I can’t bend over more than a few inches because when I do, my back hurts.’” 

This process of decompensation, or deterioration, can take an injury that may have been relatively mild, such as acute back pain, and turn it into a more serious injury that can take longer to recover from. So while it may seem contrary, Dr. Gottlieb suggests that activity and movement can be essential for quick recovery after an injury. 

Watch the full segment of Dr. Jonathan Gottlieb explaining the differences between acute and chronic back pain, here: https://youtu.be/t3bhyrKewxM