Post-MVA Back Pain Management After Toradol Injection
You should follow up with your primary care physician within 2 weeks of your accident, and immediately if your pain worsens, you develop new leg symptoms, or you experience any warning signs of serious injury. 1
What to Expect from Your Toradol Injection
Onset and duration: Your Toradol (ketorolac) injection will begin working in approximately 30 minutes, with maximum pain relief occurring 1-2 hours after the injection, and effects lasting 4-6 hours. 2
Effectiveness: Toradol provides pain relief comparable to opioid medications like morphine for moderate to severe pain, though 25% or more of patients may experience limited response. 3, 4
Duration limits: Toradol should not be used for more than 5 days total due to risks of gastrointestinal bleeding and kidney problems, especially if you are over 65 years old. 2, 4
Immediate Self-Care Instructions (Next 2 Weeks)
Stay active and avoid bed rest—this is the single most important recommendation for back pain recovery. 1, 5
Continue normal activities as much as pain allows, gradually increasing activity levels. 1
Avoid prolonged bed rest, which delays recovery and worsens outcomes. 1, 5
Use over-the-counter NSAIDs (like ibuprofen or naproxen) for ongoing pain management if you have no contraindications. 1, 5
Warning Signs Requiring Immediate Medical Attention
Seek emergency care immediately if you develop any of these red flags: 5, 6
- Loss of bowel or bladder control (inability to urinate or defecate, or loss of sensation when wiping)
- Numbness in the groin or "saddle area" between your legs
- New weakness in your legs, especially if progressive or affecting both legs
- Severe or worsening leg pain that shoots down below the knee
- Fever, unexplained weight loss, or night sweats
Follow-Up Timeline with Your Primary Care Physician
Schedule an appointment within 2 weeks (ideally at the 2-week mark from your accident) for reassessment. 1
At this visit, your doctor should:
Assess whether your pain and function have improved. 1
Use the STarT Back screening tool to determine your risk of developing chronic pain and guide further treatment decisions. 1, 7
Decide if you need referral to physical therapy, pain management, or specialist care based on your recovery progress. 1, 7
If your pain is not improving or is worsening, contact your doctor sooner than 2 weeks—do not wait. 1
What Happens If You're Not Better at 2 Weeks
Your primary care physician will stratify your risk using the STarT Back tool: 1, 7
Low risk: You'll be encouraged to continue self-management with reassurance and activity modification. 7
Medium risk: You'll be referred to physical therapy with a structured treatment plan. 7
High risk: You'll be referred to physical therapy with comprehensive biopsychosocial assessment, addressing both physical and psychological factors contributing to pain. 7
Additional Pain Management Options
If you need additional pain relief after the Toradol wears off: 1, 2
First-line: Continue NSAIDs (ibuprofen 400-600mg every 6-8 hours or naproxen 500mg twice daily) with food to protect your stomach. 1
Combination therapy: Aspirin + acetaminophen + caffeine combinations can be effective for moderate pain. 1
Avoid: Do not use opioid medications chronically, as they can lead to dependency and rebound headaches without improving long-term outcomes. 1
Work and Activity Considerations
Discuss a return-to-work plan with your doctor if you've been off work, as early return with modifications is better than prolonged absence. 1
Your doctor can provide a "fit note" describing work modifications you may need during recovery. 1
Common Pitfalls to Avoid
Do not remain on bed rest—this is outdated advice that worsens outcomes. 1, 5
Do not delay follow-up if you develop leg symptoms, as radicular pain (sciatica) requires different management than simple back pain. 5
Do not use Toradol beyond 5 days or take multiple NSAIDs simultaneously without medical supervision. 2, 4
Do not ignore psychosocial factors like work stress, fear of movement, or depression, as these predict outcomes more strongly than physical findings. 1, 6