My rule was actually tested and does work.
RewriteEngine On
RewriteRule ^get/([0-9]+)$ get.php?id=$1 [NC,L]
The NC makes it case insensitive and the L makes it stop processing once it has matched on that rule.
The second rule you posted in there will never be reached in the schema domain.com/get/123 as the first rule satisfies the match.
Perhaps your mod_rewrite module is not enabled?
If you're doing this simply to change the name of the file that is being saved it would be much more effective to send the correct headers with the file.
header('Pragma: public');
header('Cache-control: must-revalidate, post-check=0, pre-check=0');
header('Cache-control: private');
header('Expires: 0');
header('Content-Type: image/jpeg');
header('Content-Transfer-Encoding: binary');
header('Content-Length: '.filesize('filename.jpg') );
header('Content-Disposition: attachment; filename=filename.jpg');