Purpose <p>Acute nonspecific low back pain is prevalent in older adults and generally has a favorable prognosis. The first line of treatment should be non-pharmacological. The aim of the present study was to investigate whether the use of pain medications and satisfaction with care received exert an influence on the intensity of acute low back pain in older adults in a 12-month period.</p> Methods <p>A longitudinal observational study was conducted with people aging 55 years and older. Older adults with acute low back pain were followed up for 12 months. Pain intensity was measured using the Visual Analogue Scale. Satisfaction with care was self-reported. Generalized estimating equation models were used for longitudinal analysis.</p> Results <p>Mean pain intensity was 4.82 points at baseline. Pain was considered moderate in most of the participants, 74% of whom took pain medications and 58% reported being satisfied with treatment. Pain intensity diminished over time. The use of medications was not a determinant in this reduction (OR 0.87 IC95%0.67–1.14) and individuals satisfied with treatment were more likely to have lower pain intensity (OR1.27 IC95%1.01–1.59) after 12 months.</p> Conclusions <p>Pain intensity tended to dimmish over a 12-month period, especially in individuals with intense pain. However, this reduction was not influenced by the use of pain medications. Older adults satisfied with the treatment received had a greater tendency toward a reduction in the intensity of low back pain.</p>