When Should I See My Doctor
If you have back pain and have lost feeling or movement in your limbs or are having problems controlling your bowels or bladder, call triple 000 immediately and ask for an ambulance.
You should see your doctor or other health care professional for further advice if:
- your pain bothers you
- your back pain doesnt improve after a few weeks or worsens
- you have symptoms such as weight loss, tingling or numbness in the legs, or problems with bladder and/or bowel control
- you have osteoporosis
You should see your doctor as soon as possible, if you have a history of cancer, are prone to infection, or use intravenous drugs.
For most people, back pain will resolve in a few weeks with appropriate self-care. After 2 months, 9 out of 10 people will recover from back pain.
Other Conditions That Cause Back Pain In Older Adults
We often see a range of less serious but still painful spine conditions in seniors. Most patients with these conditions will not require surgery. Physical therapy, medication, injectable anesthetics, or a combination of treatments usually can control symptoms.
- Degenerative disc disease, which can cause whole spine pain, and lumbar arthritis, which usually causes low-back pain, commonly develop with age and are considered wear-and-tear conditions.
- Sacroiliitis is an inflammation of the joints that connect your spine and pelvis. This condition can cause pain in the low back, glutes, and upper legs.
- Ankylosing spondylitis is an inflammatory arthritis that causes patients spines to become inflexible, resulting in a continual hunched forward position and spine pain.
- We also check for adult degenerative scoliosis and kyphosis, spine-curving conditions that can result in back pain and weakness in the lower extremities.
What Is Lower Back Pain
Low back pain can result from many different injuries, conditions or diseases most often, an injury to muscles or tendons in the back.
Pain can range from mild to severe. In some cases, pain can make it difficult or impossible to walk, sleep, work or do everyday activities.
Usually, lower back pain gets better with rest, pain relievers and physical therapy . Cortisone injections and hands-on treatments can relieve pain and help the healing process. Some back injuries and conditions require surgical repair.
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Imaging And Blood Tests
Most people do not need additional testing however, sometimes doctors order tests to rule out a specific cause for your pain or to confirm a cause for your back pain. Your doctor may order the following.
- X-rays only show bones and can help diagnose:
- Broken bones or fractures.
- Changes due to aging.
- Changes in the alignment of the spine.
What If I Dont Want Surgery For My Back Pain
Fortunately, most people with back pain dont need surgery. We usually take a conservative approach first, using a wide variety of nonsurgical spine treatments, said Dr. Guo. For example, I might send you to physical therapy or chiropractic therapy. I might recommend medications such as anti-inflammatories, muscle relaxants, or some nerve-pain medications. We offer injection therapy, including epidural injections, joint injections, and nerve blocks and ablation if your back pain fails to improve with the conservative treatments. Chances are, one of these approaches will help reduce your back pain and improve your function and quality of life.
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What Causes Lower Back Pain
Many injuries, conditions and diseases can cause lower back pain. They include:
- Strains and sprains: Back strains and sprains are the most common cause of back pain. You can injure muscles, tendons or ligaments by lifting something too heavy or not lifting safely. Some people strain their back by sneezing, coughing, twisting or bending over.
- Fractures: The bones in the spine can break during an accident, like a car crash or a fall. Certain conditions increase the risk of fractures.
- Disk problems: Disks cushion the vertebrae . Disks can bulge from their position in the spine and press on a nerve. They can also tear . With age, disks can get flatter and offer less protection .
- Structural problems: A condition called spinal stenosis happens when the spinal column is too narrow for the spinal cord. Something pinching the spinal cord can cause severe sciatic nerve pain and lower back pain. Scoliosis can lead to pain, stiffness and difficulty moving.
- Arthritis: Osteoarthritis is the most common type of arthritis to cause lower back pain. Ankylosing spondylitis causes lower back pain, inflammation and stiffness in the spine.
- Disease:Spine tumors, infections and several types of cancer can cause back pain. Other conditions can cause back pain, too. These include kidney stones and abdominal aortic aneurysm.
- Spondylolisthesis: This condition causes the vertebrae in the spine to slip out of place. Spondylolisthesis leads to low back pain and often leg pain as well.
More Advanced Care Options
Surgery When other therapies fail, surgery may be considered to relieve pain caused by worsening nerve damage, serious musculoskeletal injuries, or nerve compression. Specific surgeries are selected for specific conditions/indications. However, surgery is not always successful. It may be months following surgery before the person is fully healed and there may be permanent loss of flexibility. Surgical options include:
Implanted nerve stimulators
- Spinal cord stimulation uses low-voltage electrical impulses from a small implanted device that is connected to a wire that runs along the spinal cord. The impulses are designed to block pain signals that are normally sent to the brain.
- Dorsal root ganglion stimulation also involves electrical signals sent along a wire connected to a small device that is implanted into the lower back. It specifically targets the nerve fibers that transmit pain signals. The impulses are designed to replace pain signals with a less painful numbing or tingling sensation.
- Peripheral nerve stimulation also uses a small implanted device and an electrode to generate and send electrical pulses that create a tingling sensation to provide pain relief.
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How Can I Relieve My Back Pain
Back pain is among the most common ailments. Unfortunately, there are almost too many treatments for it. This makes choosing the one that is right for you and your unique back pain difficult. In addition to the many causes of back pain, your back can hurt in so many different areas.
Here are 12 back pain tips:
Chronic Lower Back Pain
When back pain continues for more than three months, it is considered chronic. Although for most people an episode of back pain is over by that time, in some cases it progresses and can have a major impact on ones ability to function. For some patients, physical therapy with local heat or ice application , combined with a home exercise program and education in proper positions for lifting and other movement techniques can make a major difference. Patients must learn to tolerate a certain degree of pain, or they may allow themselves to become more disabled than necessary. Patients at the Hospital for Special Surgery have had success with graded exercise to work through the pain, gradually increasing the exercise quota at each session so they can learn to tolerate more exercise in spite of the pain, and get back to work and activities. Read more detail on this topic in .
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How Is Back Pain Evaluated And Diagnosed
In many cases, your healthcare provider may get all the information they need from interviewing you about your symptoms, health history and lifestyle and then doing an exam. However, sometimes image tests are necessary. These may include:
- A medical spine provider who specializes in back pain.
- An orthopaedic provider who specializes in bones and joints.
Your healthcare provider may also recommend a therapist or psychiatrist if youre struggling to cope with your pain.
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Prevention Of Back Pain
You may be able to prevent back pain from overuse or improper body mechanics. The following recommendations can help you have a healthy back and lifestyle:
- Perform regular exercise that keeps your back muscles strong. Exercises that increase balance and strength can decrease your risk of falling and injuring your back or breaking bones. Exercises such as tai chi and yoga or any weight-bearing exercise that challenges your balance are good ones to try. Remember to warm up before exercise or other physical activities.
- Eat a healthy diet that includes enough calcium and vitamin D, nutrients that keep your spine strong.
- Maintain a healthy weight. Being overweight can put unnecessary and injury-causing stress and strain on your back.
- Practice good posture and avoid slouching. Try to remember to support your back when sitting or standing.
- Avoid lifting heavy items whenever possible. If you do lift a heavy item, use your leg and abdominal muscles instead of your back.
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Medication From The Store
There are two kinds of over-the-counter pain relievers that frequently help with back pain: nonsteroidal anti-inflammatory drugs and acetaminophen. Both have some side effects, and some people may not be able to take them. Talk to your doctor before taking pain relievers. And don’t expect medication alone to solve your pain problem. Studies show you’ll probably need more than one type of treatment.
Treatment Of Back Pain
Doctors treat back pain with various options, including medications, nonsurgical treatments, and surgical treatments.
Medications
- Over-the-counter pain relievers taken by mouth or applied to the skin.
- Anti-inflammatory drugs taken by mouth to relieve pain and inflammation.
- Muscle relaxants for some types of chronic back pain from muscle tension.
- Anti-inflammatory or numbing injections for certain types of back pain that radiates or travels due to nerve compression or irritation.
- Prescription pain relievers for severe acute back pain.
Other Treatments
- Use cold packs to help relieve some back pain and hot packs to increase blood flow and promote healing in the muscles and tissues of the back.
- Avoid bedrest instead, limit activities or exercise that cause pain. Gradually increase physical activity as tolerated.
- Get physical therapy to help strengthen the muscles that support the back, which can improve mobility, posture, and positioning. Strengthening exercises can also help decrease pain. Check with your doctor or physical therapist before starting any exercise routine.
- Lifestyle changes teach you to:
- Move your body properly when performing daily activities, especially those involving heavy lifting, pushing, or pulling. Avoid any activities that cause or increase pain.
- Practice healthy habits such as exercise, relaxation, regular sleep, healthy diet, and quitting smoking.
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You Were In A Car Accident
If youre able to walk away from a rear end crash and feel OK, you may decide not to get checked out by a doctor. However, whiplasha violent backward-and-forward jerk of the headcan create tears and inflammation of the muscles and ligaments in the neck and upper back, explains Dr. Chang. See your doctor if you suspect whiplash, especially if you have other symptoms like fatigue, dizziness, and pain in your neck.
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% Of People Will Experience Back Pain At Some Time But There Are Ways To Find Relief
As people enter middle age, they are more likely to experience bouts of low back pain. In fact, according to the Harvard Special Health Report Men’s Health: Fifty and Forward, back pain affects about four in five Americans at some point in their lives and equally strikes men and women.
Age is often the culprit. Over time, the bones and joints in your lower back begin to change. Your discs tend to wear out and sometimes become fragmented. These structural alterations sometimes cause pain.
Another cause of low back pain, although it occurs less often, is a herniated disc. Sometimes, a disc pushes outside the space between the bones and compresses a nerve at the point where it branches off the spinal cord. When the sciatic nerve that leads into the buttocks and leg is affected, the pain is called sciatica.
Yet, most cases of low back pain stem from strain or sprain due to simple overuse, unaccustomed activity, excessive lifting, or an accident. In most cases the best move is to wait and see if the pain resolves on its own. If the pain does not improve after three to four days, then it’s time to see a doctor.
However, depending on the source of your back pain and its severity, you might try a few home remedies for low back pain to help ease the pain until your back returns to normal. Here are several options to consider:
Complementary therapies. Several types of complementary therapy may be helpful for relief from low back pain. These include:
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Maintain A Good Posture
If you want to alleviate lower back pain with minimal effort, pay attention to your hip and spine muscles and joints. Prevent stress and fatigue on the spine by monitoring your posture and adjusting your neck, shoulder, and back alignment.
Poor, unsupported posture can cause several issues in the back and lead to an increase in pain.¹ You can also prevent stress to the joints and hips by avoiding sitting for prolonged periods since it can increase pressure on your spinal disks. Try using a standing desk at work or take short-distance walks every hour to relieve the load on your disks.
Another way to avoid fatigue that leads to lower back pain is to rotate activities so that the joints and muscles have a break.² For instance, consider switching to a seated position if youve been standing for a long period. These small lifestyle changes help prevent stress, strain, and fatigue on the same sets of joints and muscles.
Age And Gender Issues
Age and gender are important factors to consider when diagnosing low back pain. In a young patient, a benign tumor of the spine called an osteoid osteoma may be the culprit. Inflammatory bowel disease in young people can be connected with spondylitis and sacroiliitis . Low back pain from disc disease or spinal degeneration is more likely to occur as people get older. Conditions such as abdominal aneurysm or multiple myeloma are also considered in older individuals.
Osteoporosis and fibromyalgia are much more common triggers of back pain in women than in men. Osteoporosis is a progressive decrease in bone density that leaves the bones brittle, porous and prone to fracture. Fibromyalgia is a chronic disorder that causes widespread musculoskeletal pain, fatigue, and multiple tender points in the neck, spine, shoulders, and hips.
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How To Get Out Of Bed
To get out of bed safely:
Alternatively:
How Is Lower Back Pain Diagnosed
Your provider will ask about your symptoms and do a physical exam. To check for broken bones or other damage, your provider may order imaging studies. These studies help your provider see clear pictures of your vertebrae, disks, muscles, ligaments and tendons.
Your provider may order:
- Spine X-ray, which uses radiation to produce images of bones.
- MRI, which uses a magnet and radio waves to create pictures of bones, muscles, tendons and other soft tissues.
- CT scan, which uses X-rays and a computer to create 3D images of bones and soft tissues.
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Electromyography to test nerves and muscles and check for neuropathy , which can cause tingling or numbness in your legs.
Depending on the cause of pain, your provider may also order blood tests or urine tests. Blood tests can detect genetic markers for some conditions that cause back pain . Urine tests check for kidney stones, which cause pain in the flank .
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Exercise To Loosen Muscles
Although it may seem counterintuitive to exercise when lower back pain is causing you grief, the right kind of movement can help eliminate the discomfort. Its always important to consult your physician before you engage in exercise when you have pain, but this conversation is well worth having if youre suffering.
First, you should keep in mind that not all exercise is beneficial in combating back pain. Try to avoid toe-touch exercises and sit-ups, which may add to the stress on your spine instead of relieving it. Leg lifts are another exercise to stay away from when you are hurting. If your core is not strong, leg lifts could be too demanding on your body if youre already experiencing pain.
Several types of exercises can be useful when you need to relieve back pain. Partial crunches can aid in strengthening your core without applying too much pressure to the area. Slow and controlled wall-sit exercises may also be useful. Other repetitions to consider include bringing each knee to the chest in succession, pelvic tilts, and swimming.
