What are the home care instructions for a patient with acute low back pain after receiving Toradol (ketorolac) in the office?

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Home Care Instructions for Acute Low Back Pain After Toradol (Ketorolac) Treatment

Medication Management at Home

Continue oral NSAIDs as your primary pain medication, as they have good evidence for moderate pain relief in acute low back pain. 1

  • Take oral ketorolac 10 mg every 4-6 hours as needed (maximum 4 doses daily) if prescribed, but do not exceed 5 days total combined duration including the injection you received in the office 2
  • Alternatively, use over-the-counter ibuprofen 600 mg every 8 hours or naproxen 500 mg twice daily if ketorolac is not prescribed 1
  • Take NSAIDs with food to minimize stomach irritation 2
  • If NSAIDs alone are insufficient after 2-3 days, add a skeletal muscle relaxant such as cyclobenzaprine 5-10 mg at bedtime for short-term use (≤1-2 weeks maximum) 1, 3

Critical Medication Warnings

Stop ketorolac immediately and seek medical attention if you experience: 2

  • Black, tarry stools or vomiting blood (signs of gastrointestinal bleeding)
  • Severe stomach pain or persistent heartburn
  • Unexplained weight gain or swelling in legs/feet
  • Difficulty breathing, chest pain, or weakness on one side
  • Yellowing of skin or eyes, dark urine, or severe fatigue
  • Skin rash, blisters, or fever

Do not take ketorolac for more than 5 days total (including the office injection), as prolonged use significantly increases risk of serious bleeding and kidney problems 2, 4

Activity and Self-Care Instructions

Remain active and avoid bed rest—this is crucial for faster recovery. 3, 5

  • Continue normal daily activities as much as pain allows 3
  • Avoid prolonged sitting or standing in one position 3
  • Do not stay in bed for more than a few hours at a time, as bed rest actually prolongs recovery 3
  • Apply heat (heating pad, warm shower) for 15-20 minutes several times daily for short-term relief 5
  • Perform gentle stretching and walking as tolerated, gradually increasing activity each day 3, 5

When to Avoid Opioids

Do not request or accept opioid prescriptions (such as oxycodone, hydrocodone, or codeine) for this acute low back pain. 1

  • Opioids provide no better pain relief than NSAIDs for acute low back pain but cause significantly more side effects including drowsiness, dizziness, nausea, and constipation 1
  • Opioids carry risks of dependence, with increased risk starting after just 3 days of use 1
  • Studies show that adding opioids to NSAIDs does not improve pain outcomes at 7 days compared to NSAIDs alone 1

Expected Recovery Timeline

  • Most acute low back pain improves significantly within 1-2 weeks with appropriate treatment 1
  • Maximum pain relief from NSAIDs typically occurs 2-3 hours after each dose 6
  • If pain is not improving after 5-7 days, contact your healthcare provider for reassessment 3

Red Flags Requiring Immediate Medical Attention

Seek emergency care if you develop: 3

  • Loss of bowel or bladder control
  • Numbness in the groin or inner thighs
  • Progressive leg weakness
  • Severe pain that worsens despite medication
  • Fever with back pain
  • History of cancer with new back pain

Follow-Up Care

  • Schedule a follow-up appointment if pain persists beyond 2 weeks 3
  • Keep a pain diary noting what activities worsen or improve your symptoms 3
  • If you have risk factors for NSAID complications (age >65, history of ulcers, kidney disease, heart disease, or taking blood thinners), contact your provider within 2-3 days to discuss safer alternatives 2, 4

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Guideline

Alternative Medications for Sciatica and Chronic Back Pain

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2026

Guideline

Management of Chronic Lower Back Pain Without NSAIDs

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2026

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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