Back pain: member guide

Back pain is a common condition affecting people all over the world. Up to 80% of people worldwide report back pain in their lifetime. This may impact their activity, employment, mental health, and overall quality of life.

Back pain has multiple causes and can be acute (sudden) or chronic (long-term). Acute pain is typically triggered by an injury or overuse and usually resolves within a few weeks to months. Chronic pain can last for more than a few months.

Causes of low back pain include overuse, injury, illness, or changes that happen with age, such as arthritis. In most cases, it's not clear what causes lower back pain.

How is back pain diagnosed?

A physical exam is the main way to diagnose low back pain. Your doctor will examine your back, check your nerves by testing your reflexes, and make sure that your muscles are strong. Your doctor may also ask questions about your back and overall health.

Most people don't need any tests right away. Tests often don't show the reason for your pain and may show findings that are not causing the pain.

If the pain lasts more than six weeks or you have symptoms that your doctor is more concerned about, then your doctor may order tests. Tests may include an X-ray, CT scan, or MRI. Other tests such as a bone scan or nerve conduction test may also be needed.

Low back pain: Should I have an MRI?

If additional tests like an MRI or CT scan are needed, your copay will vary based on the provider and/or location of the test. Search for the name of the test in the Surest app or website to compare locations and costs. Then ask your doctor to send your imaging order to the location that works for your budget. The cost for an X-ray is often bundled into the service and covered with a single copay through the Surest plan.

What are common treatments for back pain?

Self-care

Most back pain gets better within four to six weeks with self-care. The National Institutes of Health recommends:

Don’t stay in bed and rest. Keep moving if you can.
Hot or cold packs may provide pain relief so you can exercise safely
If the pain allows, do regular exercises to keep your abdominal and lower back muscles strong.
Over-the-counter pain medicine can help
Maintain a healthy body weight. Extra weight stresses your back.
Get your sleep. If you are a side-sleeper, try squeezing a pillow between your legs Back-sleepers can try a pillow under their knees.
Pay attention to posture and check your workstation ergonomics
Reduce stress, which can cause muscles to tense

Physical therapy

Physical therapy can help reduce your pain and swelling through manual therapy, education, and techniques such as heat, cold, water, ultrasound, and electrical stimulation. Physical therapy also includes stretching, core exercises, weightlifting, and walking. Your physical therapist may teach you an exercise program so you can do it at home.

Use the Surest app or website and search “physical therapy” to find an in-network physical therapist near you, as well as convenient virtual care options that may be available. Your copay will vary based on where you go.

Medicines

Medicine can help relieve low back pain and reduce muscle spasms in some people. But medicine alone doesn't work well to treat low back pain. It should be used along with other treatments, such as walking and using heat or ice.

Your doctor may recommend several medicines, depending on how long you’ve had pain, other symptoms you have, and your past health. The medicines suggested most often are:

Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen

These seem to be the over-the-counter pain relievers that work best for low back pain. But if you can’t take NSAIDs, you can try acetaminophen instead. You can buy these kinds of medicines without a prescription. Some of them also come in stronger doses. For those, you’ll need a prescription.

Muscle relaxers

These medicines can help with severe muscle spasms that happen when the back pain starts (acute phase). Side effects are common. For example, you may feel drowsy.

Opioid pain relievers

These are very strong medicines. They are sometimes used when other medicines don't help your pain. They are usually taken for only a few days.

Antidepressants

Some of these medicines, such as duloxetine, not only treat depression but also may help with chronic pain.

Anesthetic or steroid injections

These injections don't seem to help most people with chronic back pain. They may give short-term relief to some people with leg pain from a back problem.

Low back pain: Should I try epidural steroid shots?

To find your cost for medicines, search in the Surest app or website. You may need to click a link to your pharmacy benefits site to find the copay.

Surgery

There are several types of back surgery. Some, like a discectomy, can help people who have severe symptoms. Others have not been proved to work.

If you do need surgery, you and your doctor will decide which type is best for you. Having surgery for a herniated disc or another back problem is a big decision. Types of surgeries include:

Discectomy for a herniated disc

This removes the herniated disc material that is causing the problem.

Lumbar herniated disc: Should I have surgery?

Laminectomy for spinal stenosis

This surgery relieves pressure on the spinal cord nerve roots.

Kyphoplasty and vertebroplasty

These surgeries are done to try to relieve pain from compression fractures of the spine.

Surgeries for tumors and infection

These vary by location and type.

Spinal fusion

This is surgery to join, or fuse, two or more vertebrae in the low back.

In a study of people who had sciatica caused by a herniated disc, the chances of having no symptoms or almost no symptoms three months to two years later was a little higher with surgery than with nonsurgical treatment. But, overall, most people felt better with or without surgery. Talk with your doctor about your options and consider a second opinion from a different doctor if you aren’t sure. If you need help understanding coverage, call the Member Services number on the back of your Surest card and ask to speak with a clinical advocate.

To find your copay for surgery, search the Surest app or website for the name of the surgery; the price will vary depending on the place the surgery is done. Many doctors can operate in more than one location. If you find one you prefer, let your doctor know.

What if you still have pain? We’ve got your back. Call Member Services at the number on the back of your Surest ID card and ask to speak to a clinical advocate. Our team will listen to you and help connect you with clinical programs and specialists. Remember, it’s common for people with long-term pain to also experience depression. Treating your stress and depression is as important as treating your back. Clinical advocates can help you with resources and specialists for your mental health, as well.

Other treatments

You can choose from a number of alternative treatments for your low back pain. Because some of these treatments are new or aren’t yet well researched, they may not be covered by health insurance.

Massage may reduce low back pain for a short time. It is likely to work best if you also learn to do exercises for your back and learn the best ways to lift and move to protect your back.
Acupuncture may help reduce pain and allow you to be active for a short time after treatment, but not any more than other treatments.
Acupressure uses pressure on certain points in the body to decrease symptoms. Small studies suggest that it reduces pain and allows a person to be more active.
Relaxation techniques can help reduce muscle tension, stress, and depression.
Yoga is another way to stay active and get help with relaxation and managing stress. There is some evidence that yoga may help people with chronic low back pain to control their symptoms and stay more active. But it’s not clear if yoga is more helpful than any other activity or treatment for chronic low back pain. There are different types of yoga. Talk to your doctor before you start a yoga program.

To learn more about low back pain or other types of back pain, click here for the Health Library.

To find care, Surest members can see options and prices available using the Surest app or website.

Search now

Was this helpful?

Yes

Style

Footnotes