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How Do You Diagnose Back Pain

What Are The Treatments For Lower Back Pain

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Lower back pain usually gets better with rest, ice and over-the-counter pain relievers. After a few days of rest, you can start to get back to your normal activities. Staying active increases blood flow to the area and helps you heal.

Other treatments for lower back pain depend on the cause. They include:

  • Medications: Your provider may recommend nonsteroidal anti-inflammatory drugs or prescription drugs to relieve pain. Other medications relax muscles and prevent back spasms.
  • Physical therapy : PT can strengthen muscles so they can support your spine. PT also improves flexibility and helps you avoid another injury.
  • Hands-on manipulation: Several hands-on treatments can relax tight muscles, reduce pain and improve posture and alignment. Depending on the cause of pain, you may need osteopathic manipulation or chiropractic adjustments. Massage therapy can also help with back pain relief and restore function.
  • Injections: Your provider uses a needle to inject medication into the area thats causing pain. Steroid injections relieve pain and reduce inflammation.
  • Surgery: Some injuries and conditions need surgical repair. There are several types of surgery for low back pain, including many minimally invasive techniques.

Treatment Options For Acute Lower Back Pain

Most low back pain is due to muscle strain and spasm and does not require surgery. To treat the pain, medications such as acetaminophen , nonsteroidal anti-inflammatory agents , gabapentin or pregabalin can be used. NSAIDs suppress inflammation, pain and fever by inhibiting certain inflammation-causing chemicals in the body. Acetaminophen reduces pain and fever, but does not inhibit inflammation. Gabapentin and pregabalin, medications that have been used for antiseizure activity, also have the ability to block pain. Opioids provide pain relief and may at times be prescribed to manage severe back pain. However, opioids have many problems, such as habituation, constipation and lightheadedness, and are avoided when possible and used for the shortest possible duration. Epidural injection is an option if the back pain does not respond to these treatments. Each person is different in terms of response to medication.

Other nonsurgical treatments for lower back pain include Intradiscal electrothermal therapy , nucleoplasty, and radiofrequency lesioning.

When Are Imaging Tests A Good Idea

In some cases you may need an imaging test right away. Talk to your doctor if you have back pain with any of the following symptoms:

  • Weight loss that you cannot explain
  • Fever over 102° F
  • Loss of control of your bowel or bladder
  • Loss of feeling or strength in your legs
  • Problems with your reflexes
  • A history of cancer

These symptoms can be signs of nerve damage or a serious problem such as cancer or an infection in the spine.

If you do not have any of these symptoms, we recommend waiting a few weeks.

This report is for you to use when talking with your health-care provider. It is not a substitute for medical advice and treatment. Use of this report is at your own risk.

04/2012

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When Should I See A Doctor If I Have Lower Back Pain

In many cases lower back pain stops on its own. But if it doesnt, here are some guidelines on when you may want to start seeking professional help:

  • If the pain lasts four weeks or longer
  • If the pain keeps getting worse as time goes by
  • If you are experiencing other symptoms, such as fever, major weight loss or weight gain, loss of function or weakness in extremities, bladder problems, etc.

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Hear from Carlos Bagley, M.D., Professor in the Departments of Neurological Surgery and Orthopaedic Surgery, about how robot-assisted surgery provides benefits not possible with conventional methods.

Some medications or medical conditions put patients at greater risk for low bone density, fractured vertebrae, or back pain. In these cases, we get referrals from and collaborate with oncologists, hematologists, rheumatologists, mineral metabolism doctors, and primary care doctors to reduce patients risks and manage their symptoms.

If you are worried about back pain, come see us for reassurance. The earlier you are diagnosed, the better your outcomes can be.

If you or a loved one might benefit from a back pain consultation, call or request an appointment online.

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Answers To Common Back Pain Questions

More than eight in 10 people will experience upper, mid, or low back pain at some point in their lives. Low back pain is the most common back pain. In most cases, the pain goes away over time. If your back pain is severe or does not improve, you may need medical care. Here are answers to some common questions about back pain and tips on when to seek help.

What Are The Symptoms Of Low Back Pain

Low back pain is classified as acute and chronic. Acute low back pain lasts from a few days to a few weeks. Most acute low back pain will resolve on its own. Chronic low back pain lasts for more than 3 months and often gets worse. The cause of chronic low back pain can be hard to find. These are the most common symptoms of low back pain. Symptoms may include discomfort or pain in the lower back that is:

  • Protruding or herniated disk

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Can Back Pain Be Prevented

Recurring back pain resulting from improper body mechanics may be prevented by avoiding movements that jolt or strain the back, maintaining correct posture, and lifting objects properly. Many work-related injuries are caused or aggravated by stressors such as heavy lifting, contact stress , vibration, repetitive motion, and awkward posture.Recommendations for keeping ones back healthy

Lower Back Pain And Cancer

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Cancer involving the lumbar spine is not a common cause of back pain. However, in people who have a prior history of cancer, for example, in the breast or prostate, or who have weight loss or loss of appetite along with back pain cancer needs to be considered.

Night pain can be a clue to cancer in the spine. A benign tumor called osteoid osteoma, which most often affects young people, causes pain that tends to respond well to aspirin. Multiple myeloma is a malignancy that occurs when the plasma cells in the bone marrow begin spreading uncontrollably. It is most common in older people, and can cause pain in many parts of the spine. When tumor or infection are suspected, blood tests may be ordered, including a CBC , sedimentation rate , and protein electrophoresis .

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Can Further Bouts Of Back Pain Be Prevented

Evidence suggests that the best way to prevent bouts of low back pain is simply to keep active and to exercise regularly. This means general fitness exercise such as walking, running, swimming, etc. There is no firm evidence to say that any particular back strengthening exercises are more useful to prevent back pain than simply keeping fit and active. It is also sensible to be back-aware. For example, do not lift objects when you are in an awkward twisting posture.

Do Kidney Stones Always Cause Back Pain Lets Find Out

Kidney stones are a common and painful occurrence among people of all age groups. These are essentially hard deposits, caused as a result of mineral and salt accumulation from urine inside the kidneys. This can affect different parts of the urinary tract – be it the kidneys or the bladder.

There are various signs of kidney stones. If these are not detected in time, they can cause excruciating pain and discomfort. Sometimes, the stones can be passed by increasing fluid intake. But when they may end up getting stuck in the urinary tract or cause more complications, doctors usually suggest surgery.

Dr Shakir Tabrez, Senior Consultant – Urology, Uro-oncology, Andrology, Transplant and Robotic Surgery, Fortis Hospital, Richmond Road, Bengaluru, busts some common misconceptions about this health issue.

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When Surgery Is Necessary

When conservative treatment for low back pain does not provide relief or neurologic symptoms are worsening or severe, surgery may be needed. Candidates for surgery present any of the following:

  • Reasonably good health
  • Back and leg pain limits normal activity or impairs quality of life
  • Progressive neurologic deficits develop, such as leg weakness, numbness or both
  • Loss of normal bowel and bladder functions
  • Difficulty standing or walking
  • Medication and physical therapy are ineffective

If surgery is recommended, neurosurgeons have a variety of options available to help relieve pressure on the nerve roots. If several nerve roots and discs are causing the pain or if degeneration and instability exist in the spinal column, the neurosurgeon may choose: a minimally invasive approach a more open decompression or fusing the vertebrae together with bone grafts and stabilizing them with instrumentation, including metal plates, screws, rods and cages, depending on the extent of disease. After such surgery, patients may gain restored mobility in the back, including the ability to bend over. In addition, patients may require postoperative physical therapy.

The benefits of surgery should always be weighed carefully against the risks. Although a large percentage of patients with low back pain report significant pain relief after surgery, it is not guaranteed that surgery will help.

What Type Of Doctor Should I See For Back Pain

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This depends on your condition or symptoms. If you have no obvious injury that would explain your pain, you may want to start by seeing a . This is a specialist in physical medicine who can diagnose back pain and determine whether nonsurgical treatments such as physical therapy may help. Depending on those findings, a physiatrist may also refer you to a , doctor or other type of back specialist, , for additional discussion.

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Lower Back Pain Causes

Nonspecific low back pain means that the pain is not due to any specific or underlying disease that can be found. It is thought that in some cases the cause may be an over-stretch of a ligament or muscle. In other cases the cause may be a minor problem with a disc between two spinal bones , or a minor problem with a small facet joint between two vertebrae. There may be other minor problems in the structures and tissues of the lower back that result in pain. However, these causes of the pain are impossible to prove by tests. Therefore, it is usually impossible for a doctor to say exactly where the pain is coming from, or exactly what is causing the pain.

To some people, not knowing the exact cause of the pain is unsettling. However, looked at another way, many people find it reassuring to know that the diagnosis is nonspecific back pain which means there is no serious problem or disease of the back or spine.

Low Back Pain Surgery

Spine surgery is not necessary for most people who have lower back pain. If you do need it, your doctor will recommend an appropriate procedure to address your specific symptoms and medical situation. Common spine surgeries include:

. Two or more vertebrae are permanently fused together to limit excess spinal motion. Your surgeon will use a combination of bone, bonelike material, screws, plates and rods to hold the vertebrae together so they can heal into a single unit. Spinal fusion may be done to correct spinal deformities or to increase the spines stability in severe cases of spinal osteoarthritis or herniated discs.

. Laminectomy is a surgery in which your surgeon removes the back portion of one or more vertebrae to create more space for the spinal cord or other nerves. In people with severe arthritis, bone spurs within the spinal canal can grow large enough to press on the spinal cord, causing pain and limiting mobility. In a similar surgery known as laminotomy, your surgeon will remove a small piece of bone called the lamina from the back of the vertebra.

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Diagnosing Low Back Pain

Diagnosis is made by a neurosurgeon based on history, symptoms, physical examination and results of diagnostic studies. Some patients may be treated conservatively if conservative treatment is ineffective, the physician may order imaging studies of the lower back and other tests, which may include:

Who Treats Back Pain

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Different types of health care providers treat back pain, depending on the cause:

  • Pain specialists, who are physicians including anesthesiologists with specialized training in evaluation, diagnosis, and treatment of all different types of pain.
  • Family or primary care doctors.
  • Orthopaedists, who treat and perform surgery for bone and joint diseases.
  • Neurologists, who treat disorders and diseases of the spine, brain, and nerves.
  • Neurosurgeons, who perform surgery for disorders and diseases of spine, brain, and nerves.
  • Rheumatologists, who specialize in treating musculoskeletal diseases and autoimmune disorders.
  • Physical therapists, who specialize in movement and strengthening muscles.

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Other Causes Of Back Pain

There are many other potential causes of back pain, but most are rare. Be sure to see a doctor if you experience regular back pain that does not go away.

After ruling out the more common causes of back pain, your doctor will perform tests to determine if you have a rarer cause. These can :

Back pain can have many symptoms, including:

  • a dull, aching sensation in the lower back
  • a stabbing or shooting pain that can radiate down the leg to the foot
  • an inability to stand up straight without pain
  • a decreased range of motion and reduced ability to flex the back

The symptoms of back pain, if due to strain or misuse, are usually short lived but can last for days or weeks.

Back pain is chronic when symptoms have been present for 3 months.

When Are Diagnostic Tests For Lower Back Pain Necessary

Many patients do not need X-rays in the first few weeks of pain because their pain will end up resolving. Many more do not need CT scans or MRI imaging, which are overly sensitive and often reveal abnormalities not related to the patients pain. These forms of imaging can be extremely useful, however, if a person has chronic or severe pain, and/or neurological symptoms. Blood tests may be ordered if an infection or tumor is suspected.

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Imaging Tests Used For Diagnosing Back Pain

Back pain is a common reason people miss work or visit their doctor. According to the National Institutes of Health , about 80% of adults suffer from lower back pain at one point or another. Back problems can make it difficult to enjoy life and carry out your regular daily activities. The good news is, most back pain is treatable without surgery, and medical professionals are here to help.

The first step to treating back pain is to find the cause. Your doctor may order an imaging test to determine the reason for your back discomfort. Tests such as x-rays, CT scans and MRIs allow a doctor to look into your back without performing surgery. Imaging tests are quick, painless procedures that provide valuable insight into your condition. Well look at the types of imaging tests commonly used to diagnose back pain, but first, it helps to understand what causes back discomfort. That way, youll know why your doctor ordered a specific test.

Sensations That Might Indicate A Medical Emergency

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1. Sharp pain rather than a dull ache: This could indicate a torn muscle or ligament, or a problem with an internal organ in the back or side.2. Radiating pain: This pain “moves” or shoots to the glutes or legs, which could indicate a nerve compression condition.

3. Sudden weakness in the legs: Limb weakness can be caused by compressed nerves in the spine due to conditions like sciatica or spinal stenosis. However, sudden leg weakness could also indicate a stroke.4. Incontinence: Back pain paired with inability to control the bowels or bladder might be a sign of serious nerve compression or a spine infection, such as discitis or meningitis.5. Numbness or pins and needles in the groin or glutes: This is known as saddle anesthesia and is also a sign of a serious nerve or spine condition.

If you have leg weakness, incontinence, and numbness together, you might have cauda equina syndrome, a serious illness characterized by spinal cord nerve damage. This is a medical emergency, and patients usually need surgery immediately to decompress the nerves and reduce permanent damage.

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Medical And Family History

Your doctor will ask questions about your medical and family history to help determine if an injury or underlying medical condition is the source for the back pain. Some questions your doctor may ask:

  • Can you describe your pain?
  • Where is the exact location of your back pain?
  • When did the pain start and how long have you had the pain?
  • What were you doing when you first noticed the pain?
  • How severe or bad is the pain?
  • What makes the pain worse or better?

Your doctor may ask you to rate your pain on a scale from 1 to 10 to gauge the severity of the pain and talk to you about your ability to perform activities of daily living.

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