Dear Dr. Garner,

Inspired by the beautiful weather and preseason football, I went to Prospect Park with some friends to play touch football – against my wife’s protests that I’d hurt myself.

All went well during the game, but going to sleep that night, I had terrible back pain. I have been home from work and in bed for two days.

I have called my doctor for an appointment and asked for an MRI. He refused the MRI. He told me to take Motrin or Tylenol and try to walk a little each day.

I am really hurting, and I think I should get an MRI. What do you think?

Back Pain in Borough Park

Dear Back Pain,

Back pain is one of the most common health problems in our country and is the leading cause of being unable to report to work for people under 50.

Luckily, it is usually what we call self-limiting, which means that it gets better on its own with the use of pain killers, anti-inflammatory pills and exercise.

Since the pain usually subsides on its own, most patients get an MRI only after conservative treatment has been tried and time has passed. If your pain does not resolve after a few days, see your doctor so he can do an exam and look for anything serious.

The majority of low back pain stems from muscle sprains and is not serious. Some warning signs exist that may indicate a more serious condition. Up to 66 percent of people will have low back pain in their lifetime. The great majority will return to work within a month.

Treatment Options

Here are some treatments for low back pain from muscle injury:

1. Application of heat or cold (cold initially, then heat).

2. Use a medium firm mattress – firm are less effective.

3. Physical activity. Studies have shown that bed rest of more than two days is harmful to recovery.

4. Physical therapy can include massage ultrasound, electrical stimulation and even acupuncture.

5. Short-term use of pain and anti-inflammatory medication like Motrin or Tylenol may be helpful.

6. Muscle relaxants during the first few days are beneficial.

7. Spinal manipulation by chiropractors has been shown to be helpful in improving pain and function in patients.

8. Some doctors may use anti-depressants, not for depression benefits but because they help improve back pain.

Surgery should be a last resort when conservative treatment has not been effective or a patient develops a specific neurologic symptom such as leg weakness or bladder control problems.

Most people with low back pain recover completely. So I agree with your doctor. Be patient. The odds are on your side that the pain will improve.

Here are some warning signs that low back pain may be something more serious:

• Pain lasting over six weeks

• Unexplained weight loss

• Injury in someone older than age 70

• Previous or current cancer

• Unexplained fever

• Specific nerve problem with difficulty using the arms, legs or wrists

If you don’t improve within four to six weeks, then I would consider an MRI. Seek at least two opinions prior to mention of any operation.

Dr. Garner is a Fidelis Care provider who is affiliated with New York Methodist Hospital, Park Slope. He also hosts “Ask the Doctor” on The NET, Tuesdays at 8 p.m. on Channel 97 Time Warner and Channel 30 Cablevision.