Why Does My Back Hurt
There are various causes of back pain, including muscle pain with or without muscles spasms, disc pain, joint pain, or nerve pain. In most cases, these are not harmful or dangerous.
Muscle pain is the most common acute back pain. The period of acute pain is usually limited and may be treated at home or by primary care doctors. Sometimes, these patients may be referred to doctors who specialize in back pain. Some back pain can be a symptom of a more serious problem, like a fracture, infection, or cancer in the spine, said H. Michael Guo, MD, a Duke physiatrist who specializes in spine care. These patients should be seen by spine doctors. Fortunately, spine infections and cancer are very rare and usually only affect people with special risk factors. Spine fractures are also rare and may be associated with thinned spine bones or injuries.
The Two Types Of Back Pain
But while back pain is very real and can be quite debilitating, the good news is that most cases of back pain are mechanical or non-organicmeaning they are not caused by serious conditions but rather things like a sports injury or bad posture. However, there are times when back pain can indicate an underlying issue that needs immediate attention, says Neel Anand, MD, professor of orthopaedic surgery and director of spine trauma at Cedars-Sinai Spine Center in Los Angeles. Its important to know the difference between I overdid it at the gym pain and bad pain, he says. Back pain that doesnt go away or start to feel better after a few days, intensifies, or is excruciating is always a bad sign and needs to be taken seriously. Call your doctor right away.
Sudden Onset And Wont Go Away
Again, some people have experienced minor back pain for years. But sometimes it can appear suddenly and rapidly. This is often a bad sign, especially if a couple of days pass and the pain is not any better.Lets say you are at the gym doing some squats, and pull a muscle, or you hurt your back doing yard work. These things can cause your back to hurt a lot even though your back was fine before that incident.If the pain persists for more than a day without showing signs of improving, then come to Emerald Coast Urgent Care.
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Questions To Ask Your Doctor
Whether you’re seeing your primary care doctor or sitting in the emergency department, a clinician is going to tell you what they think is the best path for your treatment. They might suggest certain diagnostic tests, medication, or action steps based upon their understanding of the issue. But it’s important to remember that health care is a team effort requiring the participation of the patient: you. MCG experts highly suggest that you ask questions so that you and your clinician can make empowered, informed decisions together. Here are some questions that you can bring with you to your clinic or hospital visit:
- What is this test for?
- How many times have you done this procedure?
- When will I get my results?
- Why do I need this treatment or drug?
- Are there any alternatives?
- Will this medicine interact with any meds I’m currently taking?
- When and how should I take my medicine?
- What should I do if I miss my dose?
- What are the possible complications or side effects?
- What can I do to help manage my care?
- What should I avoid doing to prevent my back pain from getting worse?
- What should I do if my symptoms start?
- Where and when should I get help if I get worse?
Of course, this is not an exhaustive list so if there are any questions that come up for you before, after, or during the appointment, don’t be afraid to ask. Back pain is frustrating, but you don’t have to suffer alone.
First A Review Of Spine
Because back and neck pain are so common, you may downplay your symptoms. But if you develop any of the following emergency signs, you should see a doctorimmediately:
- Loss of bowel and/or bladder function
- Worsening or disabling spine pain, such as in the neck, mid back, low back
- Arm and/or leg weakness, pain, numbness, or tingling
- Saddle anesthesia
- Difficulty with balance or walking
- Difficulty controlling hands for fine motor control
Its also important to see a doctor if youve sustained a head or other bodily injury, such as may result from a car crash or sports accident. Even if you think your injury is minor and/or didnt involve your spine, a doctors evaluation can determine if youve sustained a spinal injury.
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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.
How Can Urgent Care Help With Low Back Pain
Most of us will experience backache at some point. Acute low back pain comes on most often after lifting something, falling accidentally, or sitting for a long period. Most of the time, this is a sprain, strain, or muscle spasm and is relatively easy to treat.
Lower back pain is a common reason for seeking medical attention. It may be painful enough to be treated as an emergency rather than waiting for an appointment with your primary care provider.¹
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When To Go To An Emergency Room For Back Pains
When to go to an emergency room for back pains
Lower back pains and back pain problems are one of the most common reasons for visits to doctors offices. Although they are relatively harmless, they also are the most common cause of disability among persons under the age of fifty. Most of the time, acute low-back pain is the result of simple strain and is a self-limiting condition that will resolve in four to six weeks, with or without treatment. But since back pain can be a forerunner of disability or a symptom reflecting serious pathology, every effort should be made to seek appropriate care that is based on a definitive diagnosis. You should be weary of back pains and report them to your doctor. Although some pains are just mild and will fade away on themselves, some pains are a sign of a far more serious illness and should be reported to the nearest emergency room as they are reported. So, what magnitude of back pains should prompt a visit to the emergency room? What symptoms should you look out for?
As earlier mentioned, some back pains should not raise eyebrows because they are a result of a simple strain or too much physical activity involving your back. Although this is the case, some pains need to be evaluated by a qualified medical practitioner to ascertain the exact problem. If you experience any of the following symptoms accompanied by back pains, then make a point of visiting the nearest emergency room as soon as you possibly can
What To Expect When You’re At The Hospital
When you arrive at the hospital, a emergency department clinicianeither a doctor, nurse, or physician’s assistantwill ask you a series of questions to figure out the source of the problem. They’ll ask you how long you’ve been experiencing the symptoms and if you can identify anything specific causing the pain. They’ll ask you about any signs that may indicate a more threatening condition .
Next, “the ED clinician will do a physical exam that will focus on looking for the most serious causes of low back pain,” says Dr. Popko. “She will look for motor weakness in legs or arms, or sensory abnormalities, particularly in the genital or groin area. She is typically looking for serious spine conditions or non-spine conditions.”
Spine conditions could include disc or nerve damage, while non-spine conditions could mean issues relating to the blood vessels near the spine.
If you’ve been experiencing back pain for less than six weeks and the doc doesn’t note anything alarming, you most likely won’t be sent for further testing. However, if your clinician does note something as a red flag, they may order you an ultrasound, CT scan, or whichever imaging they think is the most appropriate.
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Back Pain Paired With Leg Weakness
Nobody likes back pain, but if that pain is paired with other symptoms, it is even worse. After a trauma, some people also experience leg problems. This can include numbness or tingling, or even severe pain in your legs, even though you didnt injure your legs. In extreme cases, people are even unable to walk.If the pain is spreading, or affects other areas of your body, its important to get your back checked.
How To Know When To Go To The Emergency Room
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Home care is often the first choice when caring for an injury or illness. Bandages, over-the-counter painkillers, and resting are some of the most effective ways to help you back to good health. Sometimes, though, home care cant fix the problem.
How to know when to go to the emergency room can save you time and money when its not a necessary trip, and possibly save your life in other situations.
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What Urgent Care Can’t Do
Note that urgent care is not an emergency room. There’s sometimes confusion between urgent care centers and stand-alone emergency centers. They will refer you to one or get you admitted to a hospital if needed. Some urgent care centers don’t have doctors, but they can still prescribe painkillers and other medications.
For lower back pain, it’s best to find an urgent care center with an actual doctor, if possible.
There are urgent care facilities that are farther away from hospitals, making things more difficult if you need admission. Similarly, urgent care centers are not legally required to treat you if you cannot pay. Before you even see the doctor, some expect you to have money so they know you can afford the care.
Additionally, urgent care facilities are not meant to replace your doctor. They will help out in the short term, but you should go to your doctor if your back pain is persistent.
Some people try to use these facilities for primary care, but it is not what they are meant for. They are meant to take the strain off of emergency rooms by siphoning off people who need immediate medical attention but aren’t in danger of dying, being permanently disabled, or having other majorly adverse outcomes.
Types Of Back Pain Emergencies
If you experience any of the abovementioned symptoms, your condition may be related to any the following back pain emergencies.
1. Spinal Fracture
Spinal fractures are caused by accidents or high-energy trauma. One of its initial symptoms is severe back pain that gets worse with movement. If the nerves and/or the spinal cord are involved in the fracture, the person may also experience bladder or bowel dysfunction, tingling, weakness in the limbs and numbness.
2. Cauda Equina Syndrome
Cauda equina is the bundle of spinal nerves at the end of the spinal cord. CES occurs due to spinal nerve compression which also disturbs the sensory and motor function of the bladder and lower extremities. At its worst, CES may lead to permanent paralysis. Symptoms of CES include severe low back pain, motor weakness, pain in one or both legs, sensory loss, inability to feel anything in body parts that sit on a saddle, urinary or bowel incontinence, sensory abnormalities in the bladder or rectum and loss of reflexes in the extremities.
3. Severe Herniated Disc
4. Metastatic Spinal Cord Compression
5. Vertebral Osteomyelitis
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Symptoms That Warrant A Trip To The Er
It can be hard to tell when your best bet is to rush to the emergency room.
When you wake up in the middle of the night with an alarming symptommaybe its a high fever or splitting headacheits hard to know whether to rush to the emergency room or not. You dont want to overact, but you definitely dont want to underreact either. So how do you know when that stomach pain needs to be treated ASAP or if that numb feeling can wait until morning to deal with? We spoke to Ryan Stanton, MD, a board-certified emergency physician and spokesman for the American College of Emergency Physicians to find out.
People Tend To Ignore Back Pain Problems
There is a tendency for people to tolerate their back pain because they may not understand the potential for real problems that can come from it. While back pain can be temporary and mild, it is always a good idea to pay attention to the signs of something more. Remember, if the pain is unbearable, there is a reason for it, and the best thing to do is make an emergency visit to avoid further complications.
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When Is Sciatica An Emergency Situation
While sciatica may involve alarming and excruciating pain, it is commonly not serious. But if you experience any of the symptoms below, please seek professional help immediately. Here are some rare cases where your sciatica may be more severe than you think:
- When your symptoms occur in both legs, it is known as bilateral sciatica. It can cause dysfunctions with your bladder and bowel movement. Also, it is possible to feel an altered sensation or malfunction in your genital area, which may indicate cauda equina syndrome. It is another rare condition. Both these can sometimes cause paralysis.
- When your sciatica happens after experiencing a trauma or accident, seek help. Also, if you have sciatica accompanied by loss of appetite, fever, or other abnormal symptoms.
- When your sciatic pain keeps on getting worse and does not show any improvement, consult with a doctor. There is a possibility of nerve damage, especially when you feel weakness in your leg.
Why Back Pain Requires A Team Approach To Care
Whether back pain requires surgery or is manageable with conservative treatment, its important to see a spine specialist for diagnosis and care. The doctors at our Spine Center work as a team with experts in nerve, muscle, and bone conditions, as well as nurses and physical therapists who work closely with patients to manage symptoms and reduce the risk of recurrence.
Each week, our multidisciplinary team meets to discuss challenging cases and educate each other on the latest research and techniques. Together, we see a range of patients with complex medical needs. For example, if a patient with a spinal infection is taking a medication that suppresses the immune system, such as immunotherapy for cancer, we work together to find an effective treatment that is safe for their unique needs.
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Laboratory And Radiographic Testing
Patients with low back pain of less than 6 weeks duration should be treated conservatively unless red flags are pres- ent.6 Imaging is not warranted for most patients with acute low back pain. Without signs and symptoms indicating a serious underlying condition, imaging does not improve clinical outcomes in these patients. For even patients with a few of the weaker red flags, 4 to 6 weeks of treatment is appropriate before imaging studies are considered. Several laboratory studies and radiographic tests, however, can be used to evaluate low back pain.
Tables 7 and 8 list these studies and tests but urgent care providers are advised to consult published guidelines to determine when they are appropriate for a particular patient.8,9
Management Numerous treatments have been recommended for acute low back pain. Each has its own merits and demerits. It is, however, good news for urgent care providers to know that the prognosis for acute low back pain is excellent and up to 90% of patients will improve on their own.9 Treatment protocols for acute low back pain are summarized in Table 9.
Discussion Acute low back pain that is uncomplicated is a self-limiting condition that does not require imaging or laboratory studies. In our opinion, urgent care providers need a good understanding of the anatomy of the back to better evaluate and treat patients with acute low back pain. They should also be vigilant to note red flags associated with a patients low back pain.
References
When Should Lower Back Pain Be Considered An Emergency
Most cases of lower back pain resolve in a few days with self-care, such as heat/ice or over-the-counter painkillers. Bed rest is not recommended, as it can often result in stiffness and a slowed recovery.
Lower back pain should be considered an emergency when it is combined with: severe abdominal pain, unexplained weight loss, unexplained fever, loss of control of your bowels or bladder, or inability to move one leg.² ³
Any of these can indicate that something more serious is going on, and in these cases, you should go to an emergency room. Otherwise, your best course of action is to take painkillers, avoid strenuous activities, and contact your primary care provider if the pain lasts more than a week.
However, urgent care is a good option if you are in enough pain that you can’t engage in everyday activities or sleep, NSAIDs aren’t cutting it, and your doctor is busy or unavailable.
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