FLORIDA'S ONLY JOINT COMMISSION-ACCREDITED URGENT CARE
FLORIDA'S ONLY JOINT COMMISSION-ACCREDITED URGENT CARE · ONE OF JUST 8 NATIONWIDE
FLORIDA'S ONLY JOINT COMMISSION-ACCREDITED URGENT CARE
FLORIDA'S ONLY JOINT COMMISSION-ACCREDITED URGENT CARE · ONE OF JUST 8 NATIONWIDE
Same-visit physician evaluation, on-site X-ray when indicated, muscle relaxants and NSAIDs prescribed on-site. Walk in any day.
Joint Commission accredited. Physician on shift every day. Most insurance accepted.
Yes. TrufaMED evaluates acute and subacute back pain seven days a week under physician supervision, with on-site digital X-ray and same-visit prescriptions. Most visits run 30 to 60 minutes from check-in to discharge with a written treatment plan.
Featured Answer
For most acute low back pain — a muscle strain after lifting, a stiff morning after a long drive, a pulled paraspinal muscle from the gym — urgent care is the right level of care. A board-certified physician examines you, screens for the handful of serious findings that need imaging or the ER, and sends you home with NSAIDs, a muscle relaxant if spasm is present, and a clear activity plan.
Acute back pain falls into two broad categories, and the treatment pathway differs. The physician evaluates which pattern you have within the first few minutes of the visit.
| Feature | Non-Radicular (Mechanical) | Radicular (Sciatica) |
|---|---|---|
| Pain location | Midline or paraspinal lumbar; stays above the knee | Shoots from low back into buttock, down one leg, often below the knee |
| Underlying cause | Muscle strain, ligamentous sprain, facet joint irritation | Lumbar nerve root compression — typically L5 or S1 from disc herniation |
| Quality | Dull, achy, worse with movement; relieved by rest or heat | Sharp, burning, electric, with tingling or numbness in a dermatomal pattern |
| Exam finding | Paraspinal tenderness, limited flexion, negative straight-leg raise | Positive straight-leg raise, diminished reflex, possible weakness in foot or leg |
| Imaging on first visit | Usually not needed — no red flags, improves in days | X-ray only if red flags; MRI via outpatient referral if symptoms persist 4-6 weeks |
| First-line treatment | NSAIDs, short-course muscle relaxant, heat, activity modification | NSAIDs, neuropathic adjuvants when appropriate, short oral steroid taper in selected cases, physical therapy |
| Typical course | 80% resolve within 2-4 weeks with conservative care | 70-80% resolve within 6-12 weeks; persistent cases may need spine referral |
The distinction matters because the treatment plan and the prognosis are different. Mechanical back pain — the most common reason patients walk in — responds beautifully to a few days of anti-inflammatory medication, a short course of a muscle relaxant at night, heat, and a graduated return to normal activity. Radicular pain — sciatica from a disc pressing on a nerve root — is a different problem. The pain pattern is different, the exam findings are different, and the recovery curve is longer. Our physicians identify which pattern you have on first visit and match the plan to the pattern.
A third category — back pain with red flags — is rarer but matters most. Red flags move the workup from urgent care to imaging, lab work, or the emergency department. They include unexplained weight loss, fever, history of cancer, recent significant trauma, progressive neurologic deficit, saddle anesthesia, new urinary or bowel changes, and intravenous drug use. These are covered in a dedicated section below.
Back pain is almost always diagnosed clinically — by history and physical examination, not by imaging. The physician uses targeted exam maneuvers to localize the problem and to screen for nerve root or spinal cord involvement.
The straight-leg raise is the single most useful physical exam maneuver for radicular pain. The physician passively lifts the straight leg while you lie on your back. Pain that shoots down the back of the thigh and below the knee between 30 and 70 degrees of elevation is a positive test, and it correlates well with L5 or S1 nerve root irritation. A negative test in a patient with leg pain makes nerve root compression less likely.
The neurologic exam — strength, reflexes, sensation, and gait — is the second workhorse. Asymmetric reflexes, weakness you can quantify, or a dermatomal sensory loss changes the plan. Imaging is guided by what the exam finds. Most patients with acute mechanical back pain have a completely normal neurologic exam — which is reassuring and the reason X-ray or MRI is usually not needed on first visit.
Fewer than five percent of acute back pain presentations carry a red flag, but the ones that do require escalation — urgent imaging, labs, or transfer. Our physicians screen for these on every visit.
Compression of the nerve roots at the base of the spinal cord. Signs: saddle anesthesia (numbness in the inner thighs, perineum, or genitals), new urinary retention or incontinence, new fecal incontinence, bilateral leg weakness, and severe bilateral sciatica. This is a surgical emergency. Suspected cauda equina goes directly to the emergency department for urgent MRI and neurosurgical evaluation.
Suspect after significant trauma (motor vehicle crash, fall from height), osteoporotic compression fracture in elderly patients after minor trauma, or in anyone on chronic steroids. On-site X-ray rules out most lumbar fractures quickly; CT is ordered when X-ray is equivocal or concern remains high.
Fever plus back pain, intravenous drug use, recent invasive spinal procedure, immunocompromised state, or progressive pain unrelieved by rest. Labs (CBC, CRP, ESR), blood cultures, and urgent MRI are warranted. Epidural abscess is a neurosurgical emergency.
History of cancer (breast, lung, prostate, renal, thyroid, multiple myeloma), unexplained weight loss, night pain unrelieved by position, age over 50 with new persistent back pain. Imaging and labs are ordered; oncology referral coordinated when appropriate.
Worsening weakness, new bilateral findings, or signs of upper motor neuron involvement (hyperreflexia, positive Babinski) require urgent imaging and specialist evaluation.
Red Flag Quick Reference
Most acute back pain does not need imaging. Guidelines from the American College of Physicians and the American College of Radiology are clear: routine lumbar imaging in patients with non-specific low back pain and no red flags does not improve outcomes and may cause harm. When imaging is indicated, we use our on-site digital X-ray the same visit.
Our physicians order lumbar X-ray on first visit when any of the following are present: significant trauma, age over 65 with first episode of severe pain, history of cancer, chronic oral steroid use, unexplained weight loss, suspected vertebral fracture, or concern for spondylolisthesis. We also image when pain is severe enough to limit the neurologic exam or when follow-up would be difficult.
Typical acute muscular back pain in a patient under 50 with no red flags does not need an X-ray. The findings on a plain film in this population almost never change the treatment. Getting an X-ray can actually delay recovery by anchoring the patient on a structural abnormality that is unrelated to the pain — degenerative changes are nearly universal on imaging past age 40 and do not correlate with symptoms.
MRI is reserved for persistent radicular pain (6 or more weeks despite conservative care), progressive neurologic deficit, suspected infection or malignancy, or any red-flag finding. We refer for outpatient MRI when indicated and coordinate with spine specialists.
On-Site Imaging Capabilities
What Your Physician Documents
The cornerstone of acute back pain care is evidence-based and unglamorous: anti-inflammatory medication, targeted muscle relaxation when spasm is present, and a structured return to activity. Opioids are not first-line and are avoided in routine care.
| Medication | Typical Use | Notes |
|---|---|---|
| NSAIDs (ibuprofen, naproxen, meloxicam) | First-line for inflammation and pain | Taken with food, short course (7-10 days), avoid in kidney disease or high GI-bleed risk |
| Acetaminophen | Adjunct or alternative for NSAID-intolerant patients | Maximum 3 g/day; useful in combination with NSAIDs |
| Muscle relaxants (cyclobenzaprine, methocarbamol, tizanidine) | Short course for acute spasm, best at night | Cause drowsiness; 5-7 day course typical; not for long-term use |
| Topical agents (diclofenac gel, lidocaine patch, menthol) | Local relief, low systemic absorption | Good for older patients, patients with GI or renal comorbidity |
| Short oral steroid taper | Selected cases of severe acute radicular pain | Evidence mixed; prescribed when disability is high and NSAIDs inadequate |
| Neuropathic adjuvants (gabapentin) | Persistent radicular symptoms when appropriate | Titrated, sedating initially; not first-line in acute setting |
| Opioids | Not routine; very short courses in severe cases only | Small 3-5 day supply, no refills, when other options fail or are contraindicated |
A typical TrufaMED back pain discharge includes: an NSAID for 7-10 days, a muscle relaxant at bedtime for 5-7 days, a topical agent for localized pain, heat therapy guidance, activity modification with return-to-activity milestones, and specific return precautions that tell you which symptoms mean come back immediately. Most patients do not need a follow-up visit if symptoms follow the expected improvement curve.
Our physicians actively avoid prescribing opioids for routine acute back pain. Current evidence is clear: opioids offer no better pain control than NSAIDs for back pain, delay return to normal activity, and carry a real risk of dependency. When pain severity seems out of proportion to exam findings, we re-examine the case for missed red flags rather than escalate pain medication.
The old prescription — bed rest for a week — is obsolete. Prolonged rest slows recovery and worsens deconditioning. Current evidence and our discharge instructions reflect the opposite: stay as active as the pain allows, from the first day.
Avoid heavy lifting, sustained bending, and positions that sharply worsen pain. Walk for 5-10 minutes every couple of hours. Ice is optional in the first 24-48 hours for acute strains.
Add gentle walking, easy stretching, and daily-living tasks back in. Heat therapy often feels better than ice after the first couple of days. Sleep on your back with a pillow under your knees, or on your side with a pillow between the knees.
Graduated return to exercise. Most patients tolerate easy cardio by day 7-10 and progressive resistance training by 2-3 weeks. Core and hip-stability work prevents recurrence.
For pain that is not resolving on expected curve, or for recurrent episodes, structured physical therapy is first-line. We refer to local PT clinics that take most insurance and coordinate directly with them.
Desk setup, lifting mechanics, and sleep position matter. Simple changes — elbows at 90 degrees, screen at eye level, lifting with hips and knees — dramatically reduce recurrence.
Return to us if pain worsens, new leg weakness appears, symptoms are not improving after 2 weeks of conservative care, or new red flags emerge. Otherwise, no routine follow-up needed.
Most back pain resolves without any specialist involvement. A minority of cases need orthopedic spine, neurosurgery, physiatry, or pain management. The referral trigger is specific.
Leg pain that persists 4-6 weeks despite conservative care — NSAIDs, activity modification, physical therapy — is a typical trigger for MRI and specialist referral. The MRI defines the anatomy; the specialist (usually physiatry or pain management before surgery) discusses injection or procedural options.
Worsening weakness, expanding sensory loss, or new reflex changes move the workup urgently. These patients get MRI quickly and go to orthopedic spine or neurosurgery for evaluation.
Spondylolisthesis with instability, severe stenosis, large disc herniation pressing on nerve roots, or suspected malignant or infectious pathology are referred directly.
Pain that significantly limits function at 12 weeks despite optimized medical management and physical therapy is referred for specialist input. Options discussed may include epidural steroid injection, medial branch block, or surgical consultation depending on the anatomy.
Who We Refer To
Back pain is one of the most common reasons adults visit urgent care. The quality of that first visit — a competent physician, an appropriate red-flag screen, and a sensible treatment plan — shapes whether the episode resolves in days or turns into a chronic problem.
01 · Accreditation
Florida’s Only JC-Accredited Urgent Care
Joint Commission accreditation — the same body that accredits hospitals — audits our documentation, medication safety, imaging protocols, and clinical standards every three years.
02 · Physicians
Every Visit Includes an MD
Every patient is evaluated by a board-certified physician. Led by Dr. Uri Gedalia (Chief Medical Officer) and Dr. Shane D. Naidoo (Medical Director, Emergency Medicine). Meet them on our staff page.
03 · On-Site X-Ray
Same-Visit Imaging
When imaging is indicated, our on-site digital X-ray produces same-visit results, read by the treating physician and over-read by a radiologist within 24-48 hours.
04 · Evidence-Based
Guideline-Concordant Care
Our protocols reflect current American College of Physicians and American College of Radiology recommendations — appropriate imaging, no routine opioids, active-recovery discharge plans.
05 · Insurance
Most Plans Accepted
Aetna, Cigna, UHC, Humana, Oscar*, Medicare. Self-pay patients welcome with transparent pricing. Most visits bill as a standard urgent care visit.
06 · Coordination
Referrals Handled
When specialist follow-up is needed — physiatry, orthopedic spine, neurosurgery, pain management, PT — we coordinate the referral and pass on your exam and imaging.
Most back pain is urgent-care level. A small fraction is not. The findings below move disposition directly to the emergency department.
Go to the ER or call 911 if:
If you are unsure, come in. We triage on arrival and transfer patients to the ER when findings warrant it. A same-day physician evaluation is worth it when the alternative is missing cauda equina syndrome, epidural abscess, or a surgical emergency.
The questions our physicians answer most often about acute back pain at urgent care.
TrufaMED is at 9445 Harding Ave in Surfside — minutes from Bal Harbour, Bay Harbor Islands, Miami Beach, Sunny Isles, and Aventura. Walk in without an appointment seven days a week.
9445 Harding Ave, Surfside, FL 33154 · Contact our team · Walk-in only — no appointment needed.
Monday – Friday
9 AM – 9 PM
Saturday
11 AM – 11 PM
Sunday
12 PM – 8 PM
TrufaMED is Florida’s only Joint Commission-accredited urgent care. In addition to back pain, we handle the full urgent care spectrum including stomach flu, influenza, migraine, dehydration IV, and sore throat. Most insurance accepted. Self-pay patients welcome.
A back pain urgent care visit — physician evaluation, X-ray when indicated, and same-visit prescriptions — is covered by most major plans as a standard urgent care encounter.
Physician evaluation, on-site X-ray when needed, and same-visit prescriptions in a single urgent care visit. No appointment needed. Most insurance accepted.
Medical Disclaimer: Content on this page is provided for general informational purposes only and does not constitute medical advice. Back pain causes vary by individual, and proper diagnosis requires an in-person physician evaluation. If you are experiencing new numbness in the saddle area, new loss of bladder or bowel control, rapidly progressing leg weakness, severe pain after major trauma, or any other life-threatening symptom, call 911 or go to the nearest emergency department immediately. TrufaMED Urgent Care & Concierge Medicine — 9445 Harding Ave, Surfside, FL 33154 — (305) 537-6396. Joint Commission accredited.
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