When Is Back Or Neck Pain An Emergency
Most people experience back pain or neck pain at some point in their livesand most cases are not an emergency. Bouts of spine-related pain can usually be managed at home with an over-the-counter anti-inflammatory drug, OTC pain reliever or ice and heat. Seldom is spine surgery urgently needed, and most surgical procedures are elective. However, there are times when back or neck pain requires urgent medical attention. Here, youll learn about 6 potentially serious spinal conditions and symptoms you shouldnt ignore.There are times when back or neck pain requires urgent medical attention. Photo Source: 123RF.com.
Xii 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 and opioids 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 has the ability to block pain. Opioids provide pain relief and may be prescribed to manage severe acute and chronic 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.
What Are Some Other Causes Of Lower Back Pain
The shape of your spine, and well as spinal diseases, are other culprits in lower back pain. Depending on a range of factors, your doctor may look for:
Abnormal spinal curvature. A normal spine resembles a gently curved letter S when seen from the side. Abnormal curves include:
- Lordosis, in which the spine curves too far inward at the lower back
- Kyphosis, in which the spine is abnormally rounded in the upper back
- Scoliosis, in which the spine curves from side to side, often in a C shape
Normal and abnormal curves of the spineArthritis. There are more than 100 types of arthritis, many of which can cause lower back pain. The most common types include osteoarthritis , rheumatoid arthritis, and ankylosing spondylitis.
Cauda equina syndrome . Compression of the bundle of nerves that forms below the spinal cord in the lumbar spine. It is a rare but serious disorder that requires immediate medical attention and possibly emergency surgery. CES got its name from the fact that the fanned-out bundle of nerves resembles the base of a horses tail.
Discitis or osteomyelitis.Both infections of discs and bone can cause severe pain and require prompt medical attention.
Spinal tumors. When cells divide and multiply unchecked, the result is a tumor. Both benign and malignant tumors can cause lower back pain. They can either originate in the spine or metastasize there, meaning theyve spread from somewhere else in the body.
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Lower Back Pain: What Could It Be
Do you have lower back pain? You are not alone. Anyone can experience lower back pain at any time, even if you dont have a prior injury or any of the risk factors. It is not always serious and can often get better on its own. But in some cases pain is your bodys way of telling you that something isnt right.
Learn more about lower back pain and what causes it from rehabilitation physician Akhil Chhatre, M.D., who specializes in back pain in the Johns Hopkins Department of Physical Medicine and Rehabilitation.
Ask Your Doctor About Biofeedback
In recent years, biofeedback a type of mind-body technique that uses electrical sensors to help you make subtle changes in your body has grown in popularity as an effective way to manage back pain. A suggested that biofeedback could reduce the intensity of back pain and muscle tension, both as a standalone treatment and when combined with other treatments.
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Chronic Conditions That Cause Back Pain
Conditions that can lead to chronic low back pain include spinal stenosis, spondylitis, and fibromyalgia. Spinal stenosis is narrowing of the normal spinal canal through which the spinal cord passes. Spondylitis is chronic inflammation of the spine. Fibromyalgia is a muscle disorder that features chronic muscle pain and tenderness.
Theres A Pain In Your Side
Oh, boy. Has anyone reading this ever had a kidney stone? If you have, youre well aware of the agony and the frustration of getting rid of it.
Which brings us to the next point. If you feel a sharp pain in the upper back and on your side, you should get checked out. Kidney stones often manifest these symptoms. Other possible signs of kidney stones: discomfort or tenderness while peeing, or brown- or red-hued urine. If you feel pain below the shoulder blades, you may have an issue with your gallbladder and should be seen by a doctor.
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Which Lifestyle Factors Contribute To Lower Back Pain
There are three major lifestyle factors that may affect your chances of developing lower back pain:
- Multiple studies have established a link between smoking and lower back pain. Smoking raises inflammation inside the body and hinders the body from healing itself.
- Obesity is also associated with several types of chronic pain, including lower back pain. In people with high body mass index , the stress on the spine increases, contributing to even more wear and tear.
- Your level of physical activity can also play a role in your lower back health. While a sedentary lifestyle could increase your risk of developing lower back pain, so can excessive or strenuous physical activity. Check with your doctor if you are unsure about your ideal level of physical activity.
Heres What The Study Couldnt Tell Us
The study was missing a few potentially helpful low-risk medicines. Topicals such as the lidocaine patch or capsaicin ointment were not included, which is a shame, as these can provide relief for some people, and carry little risk. I would also be interested to know if over-the-counter topical therapies containing menthol and camphor are better than placebo for low back pain. Suggestions for the future research, and the next update!
I plan to write about chronic low back pain in a future post, because there was a guideline update for that specific issue as well.
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Complete Guide To Low Back Pain
This article might ease your mind, but what about your back pain? If your pain is becoming chronic , or if you just keep having flare-ups, you may want to dive much deeper into the topic. There arent any easy answers for stubborn back pain, but there is evidence-based hope, and the PainScience.com back pain tutorial explores the topic extremely thoroughly. The main text is written for patients, but its also extensively referenced for keen readers and healthcare professionals. Read the introduction.
Back Sprain Or Strain
Symptoms typically include:
- Muscle spasms, cramping, and stiffness.
- Pain in the back and sometimes in the buttock. It may come on quickly or gradually. It most often occurs in episodes. Certain movements make it worse, and doing light activities such as walking makes it feel better. The worst pain usually lasts 48 to 72 hours and may be followed by days or weeks of less severe pain.
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Xi When Are Certain Diagnostic Tests Necessary
There is concern within the medical community that high-tech imaging methods, such as CT scan and MRI, are overused for acute low back pain. Often, these sensitive imaging techniques reveal asymptomatic abnormalities in the lumbar spine that are not the cause of the patients pain. In one study, volunteers with no history of back pain were given MRIs and 90% of those over age 60 had degenerative disc disease. MRIs that show abnormalities in the lumbar region that cause no symptoms for the patient are not helpful.
If You Have Low Back Pain Try These Steps First
- By Monique Tello, MD, MPH, Contributor
Low back pain, the scourge of mankind: it is the second leading cause of disability here in the United States, and the fourth worldwide. Its also one of the top five medical problems for which people see doctors. Almost every day that I see patients, I see someone with back pain. Its one of the top reasons for lost wages due to missed work, as well as for healthcare dollars spent, hence, a very expensive problem.
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Two Back Pain Situations You Should Take Seriously Right Away No Delay
These two back pain scenarios might be medical emergencies. They do not necessarily mean something horrible is wrong, but its extremely important to make sure.
If you are experiencing true numbness14 around the groin and buttocks and/or failure of bladder or bowel control, please consider it a serious emergency do not wait to see if it goes away. These symptoms indicate spinal cord injury or compression15 and require immediate medical attention.
And, of course, if youve had an accident with forces that may have been sufficient to fracture your spine, please seek thorough medical assessment promptly, including an X-ray to look for a fracture. You need an X-ray to ensure that your spine is not actually broken.
Isnt it rather obvious that a potential spinal fracture is an emergency?
Low Back Pain Fact Sheet
If you have had lower back pain, you are not alone. Back pain is one of most common reasons people see a doctor or miss days at work. Even school-age children can have back pain.
Back pain can range in intensity from a dull, constant ache to a sudden, sharp or shooting pain. It can begin suddenly as a result of an accident or by lifting something heavy, or it can develop over time as we age. Getting too little exercise followed by a strenuous workout also can cause back pain.
There are two types of back pain:
- Acute, or short-term back pain lasts a few days to a few weeks. Most low back pain is acute. It tends to resolve on its own within a few days with self-care and there is no residual loss of function. In some cases a few months are required for the symptoms to disappear.
- Chronic back pain is defined as pain that continues for 12 weeks or longer, even after an initial injury or underlying cause of acute low back pain has been treated. About 20 percent of people affected by acute low back pain develop chronic low back pain with persistent symptoms at one year. Even if pain persists, it does not always mean there is a medically serious underlying cause or one that can be easily identified and treated. In some cases, treatment successfully relieves chronic low back pain, but in other cases pain continues despite medical and surgical treatment.
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V Inflammatory Lower Back Pain
Although comparatively few patients have low back pain due to inflammation, the problem can be life long and can impair function significantly. The good news is that treatments can help essentially all patients, and can lead to major improvements.
Seronegative spondyloarthropathies are a group of inflammatory diseases that begin at a young age, with gradual onset. Like other inflammatory joint diseases, they are associated with morning stiffness that gets better with exercise. Sometimes fusion of vertebrae in the cervical or lumbar regions of the spine occurs. Drugs called TNF-alpha blocking agents, which are used for rheumatoid arthritis, are also used to treat the stiffness, pain, and swelling of spondyloarthropathy, when the cases are severe and not responsive to traditional medications.
People who have spondyloarthropathy have stiffness that is generally worst in the morning, and have decreased motion of the spine. They also can have decreased ability to take a deep breath due to loss of motion of the chest wall. Its important for the physician to look for problems with chest wall expansion in patients with spondyloarthropathy.
Reactive arthritis syndrome is one of the forms of spondyloarthropathy. It is a form of arthritis that occurs in reaction to an infection somewhere in the body, and it carries its own set of signs and symptoms. The doctor will look for:
How Is Low Back Pain Diagnosed
A complete medical history and physical exam can usually identify any serious conditions that may be causing the pain. Neurologic tests can help determine the cause of pain and appropriate treatment. Imaging tests are not needed in most cases but may be ordered to rule out specific causes of pain, including tumors and spinal stenosis. Occasionally the cause of chronic lower back pain is difficult to determine even after a thorough examination.
Tests include:
Blood tests are not routinely used to diagnose the cause of back pain but might be ordered to look for signs of inflammation, infection, cancer, and/or arthritis.
Bone scans can detect and monitor an infection, fracture, or bone disorder. A small amount of radioactive material is injected into the bloodstream and collects in the bones, particularly in areas with some abnormality. Scanner-generated images can identify specific areas of irregular bone metabolism or abnormal blood flow, as well as to measure levels of joint disease.
Discography involves injecting a contrast dye into a spinal disc thought to be causing low back pain. The fluids pressure in the disc will reproduce the persons symptoms if the disc is the cause. The dye helps to show the damaged areas on CT scans taken following the injection.
Electrodiagnostics can identify problems related to the nerves in the back and legs. The procedures include:
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Muscle Injury Damage And Death
Individuals who overwork the muscles can be particularly prone to a condition called rhabdomyolysis. This is characterized by the death of muscle tissue usually as the result of very strenuous activity.
The muscles of the back are some of the most utilized muscles in the body. Simple activities like standing, sitting, walking, and other, seemingly mundane postural actions all require the engagement of the lower back muscles. Combine this with demanding activities like heavy lifting and muscle injury and subsequent damage are certainly a risk.
Individuals who are most at risk of this type of overworking the back muscles are athletes and manual laborers who are consistently pushing their muscles to their limits.
If the muscles are overworked, not only can this lead to back pain and even fevers, but the tissues can die and breakdown, resulting in a release of toxins throughout the system. These toxins and muscle break-down products then enter the bloodstream which can significantly burden the kidneys. This can lead to kidney damage and in severe cases, potentially even kidney failure,
Treatment of rhabdomylosis depends on the severity of the case. In minor cases, the condition can be addressed with rest and fluid intake to help normalize the blood chemistry. In severe cases that lead to kidney damage, however, hospitalization may be necessary.
Many Doctors Are Reporting An Increase In The Number Of Patients With Lower Back Pain Post The Second Wave Of Covid
Written by Jahnavi Sarma | Published : September 20, 2021 5:12 PM IST
India witnessed a devastating second wave of the COVID-19 pandemic and the country is still reeling under the after-effects even as it readies itself to fight the third wave. The second wave claimed many lives and many surviving patients are coping with post recovery complications some of which are quite serious. This wave has affected even those who did not catch the viral disease. According to many doctors, there has been a two-fold increase in back pain cases among children in the age group of 8-20. In adults between the ages of 25 to 50 years, this increase is four-fold. The reasons for this are many but it mostly points to working from home for adults and attending online classes for children.
According to Dr Vishwajit Chavan, Orthopedic Consultant Shoulder, and Knee Arthroscopy and Joint Replacement, Apollo Spectra Pune, “Now, for over a year, due to the pandemic, children and adults are at home and doing their online schooling classes and work from home that has taken a toll on their back. Even housewives are required to do household chores in the absence of domestic help, and that too has aggravated lower back pain.” The main reason according to his is because tend to sit for long stretches at a time while working on the computer in the same position. Food habits also get disrupted and stress is a constant companion. All these lead to lower back pain.
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Muscle Strain Or Sprain
A muscle strain or sprain is the most common cause of low back pain.
A strain is a tear or stretching in a tendon or muscle, while a sprain is a tear or stretching in a ligament.
Sprains and strains usually happen when you twist or lift something improperly, lift something heavy, or overstretch your back muscles.
These injuries can cause swelling, difficulty moving, and back spasms.
Viii Lower Back Pain And Cancer
Cancer involving the lumbar spine is rare. 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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