Referred Pain To And From The Lumbar Spine
Pain in the area of the lumbar spine may be due to important problems that are actually unrelated to the back. Referred pain occurs when a problem in one place in the body causes pain in another place. The pain travels down a nerve.. Sources of referred pain to the low back may include abdominal aneurysm , tubal pregnancy, kidney stones, pancreatitis, and colon cancer. Clues to these maladies include pain that waxes and wanes over a short period, with frequent peaks of intense pain, weight loss, abnormalities found during abdominal exam, and trace amounts of blood in the urine. On the other hand, pain can be referred from the low back and be felt in another location, as is often the case with . For example, it is not rare for a patient with a slipped disc in the lower back to have pain in the back of the thigh, or in the calf or even the foot, and not have any low back pain. This situation requires a doctor to sort out the type of pain and to do the examination required to show that the pain is actually coming from the spine .
When Should You See A Doctor For Your Lower Back Pain
Most back pain caused by sprains or overuse tends to get better without treatment within a few weeks. Over-the-counter pain relievers and/or heat or cold application to the painful area can help decrease your back pain. Bed rest is not suggested.
However, there may be other causes that require attention and treatment.
When to see your doctor
Call your doctor if your back pain doesn’t get better after treating it at home for a week. It can mean there’s a bigger problem that the doctor needs to evaluate. You’ll also want to call your doctor if your back pain:
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Spreads down one or both of your legs, particularly if you have pain extending below your knee
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Is intense or constant, particularly when you lie down or at night
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Occurs with redness or swelling on your back
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Causes numbness, tingling, or weakness in one or both of your legs
When is lower back pain an emergency?
While rushing to the emergency department is probably not something you want to do, you need to take back pain seriously left side, right side, or both.
When suffering from severe back pain, a visit to the ER is recommended. It could indicate a medical emergency. Some red-flag symptoms of back issues that may indicate an emergency are a combination of any of the following:
If you experience any of the above symptoms, visit the emergency room immediately or call 911 if you’re unable to get to the emergency room on your own.
When Back Pain May Be A Medical Emergency
The underlying causes for most occurrences of back pain are non-emergent, but the intense pain and related symptoms often elevate anxiety and prompt a visit to the emergency room . While back pain is typically treated in a primary care setting or by a musculoskeletal specialist, physicians are often cautious and look for warning signs of neurologically impairing or life-threatening causes. These causes are rare, but if present, they are considered a medical emergency and warrant immediate treatment to preserve back and/or leg function.
Though rare, acute cauda equina syndrome is a serious medical emergency. It usually requires immediate medical attention. Watch Cauda Equina Syndrome Video
Back pain is considered the most common musculoskeletal cause for emergency room visits and typically involves individuals aged 18 to 65 years.1,2
This article provides a comprehensive guide to when back pain may indicate a medical emergency and the associated red-flag symptoms to watch out for.
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When Is It An Emergency
Lower left back pain can range from mildly uncomfortable to so severe pain that it ishard to function or move.
If you develop sudden, severe pain in your lower back, seek emergency medical care.
If the pain is milder, but does not resolve within 5-7 days, seek medical care.
If your symptoms worsen, are severe,or you also have fever andchills, go to the nearest medical facility and contact your healthcare provider.
Pinched Nerve Or Cervical Radiculopathy
My pain is radiating down the left side of my neck
Symptoms for Pinched Nerves
If you have a pinched or inflamed nerve in your upper left back your symptoms are most likely pain that is sharp and radiating down your neck, numbness or burning sensation, or the feeling of weakness on the upper left back.
Pinched Nerve Causes
The most common reason you are experiencing neck and shoulder pain on the left side is because of a pinched or inflamed nerve that occurs within your spine. Your nerves are the main carriers of information from the brain to the rest of the body, and vice-versa. If a nerve is pinched or inflamed, the signal of this information sending is interrupted in some way. A pinched nerve occurs when too much pressure is applied to a nerve by surrounding tissues. This can be caused by a variety of things, including compression, constriction, or overstretching of the nerve. Pinched nerves can happen as a result of things like a herniated disc, degenerative disc, and bony growths.
Treatments for Pinched Nerve
If youre suffering from a pinched or inflamed nerve we highly recommend rest for a faster recovery. Along with rest, some use medication, physical therapy, or anti-inflammatory medication to tame the inflamed nerves. Its also recommended that you isolate your neck and keep it still during your recovery time. Neck collars or immobilizers are a great way to help lead you towards a faster recovery by isolation of the neck.
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Lower Back And Hip Pain On One Side
There are many possible causes of lower back and hip pain on one side. It could be due to an injury, arthritis, or a pinched nerve. Sometimes, the pain may be caused by a muscle spasm. If the pain is severe, it is important to see a doctor to rule out any serious underlying conditions.
While lower back pain and hip pain on one side can severely restrict your ability to function, remaining active is generally the best option. Stress causes physical and mental disorders, in addition to lifestyle choices, poor posture, obesity, and sports injuries. The pain from sciatica is typically caused by a pinched nerve in the spine that then radiate down the leg. Rheumatoid arthritis can cause pain on one side of the body and pain on the other. Allergies to wheat cause adhesions, a chronic inflammatory condition that affects the large intestine. When a pinched nerve causes tingling or numbness in one or both legs, it can cause unilateral back pain. When your spinal discs outer layer is compressed, the jelly within it becomes compressed. spondylitis of the spine is the result of ankylosing spondylitis. Compression fractures, which can be caused by severe back trauma, such as a car accident or a fall, can also be caused by severe back trauma.
What Can I Do For Low Back Pain At Home
If your lower back pain has just started, the best thing you can do is start a log. Record your symptoms, times, dates and which activities trigger the pain or make it worse or better. Take this information to your family physician if the pain doesnt resolve on its own. It will make diagnosing the cause much easier.
Once you know which motion or position causes your lower back pain, try to avoid it and see if you get better. Icing the painful spot can also help. And so can over-the-counter pain relievers that help reduce inflammation. Just remember that pain killers treat only the symptom pain and not its cause.
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Complications Related To Sciatica
If you develop a loss of bladder or bowel control, contact your doctor right away. This can be a sign of a medical emergency that requires surgery to avoid permanent damage. Fortunately, this complication is rare. Most cases of sciatica go away within a few days or weeks and cause no lasting harm.
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What Type Of Doctor Should I See For Back Pain
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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What Research Is Being Done
The mission of the National Institute of Neurological Disorders and Stroke is to seek fundamental knowledge of the brain and nervous system and to use that knowledge to reduce the burden of neurological disease. NINDS is a component of the National Institutes of Health , the leading supporter of biomedical research in the world.
As a primary supporter of research on pain and pain mechanisms, NINDS is a member of the NIH Pain Consortium, which was established to promote collaboration among the many NIH Institutes and Centers with research programs and activities addressing pain. On an even broader scale, NIH participates in the Interagency Pain Research Coordinating Committee, a federal advisory committee that coordinates research across other U.S. Department of Health and Human Services agencies as well as the Departments of Defense and Veterans Affairs.
Ways To Manage Low Back Pain At Home
Back pain is one of the most common physical ailments. Studies show that eight in 10 Americans have back pain at some point in their lives, usually in the lower back.
Your might have sprained it while working in the yard or cleaning house. Or your back might hurt from an old sports injury or a chronic condition such as arthritis or ankylosing spondylitis.
Sudden or severe back pain should be checked by a doctor or a physical therapist. That also goes for pain that wonât go away.
But sometimes you can treat nagging pain and discomfort on your own.
Wilson Ray, MD, chief of spine surgery for the Department of Neurological Surgery at Washington University School of Medicine in St. Louis, says home remedies â tend to be better when they’re combined than alone.â
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Alternative/holistic Treatment Options For Left Back Pain
Alternative/ holistic methods include:
Acupuncture
This Traditional Chinese Medicine technique involves inserting thin needles at different points on the body. This practice is believed to trigger the release of pain-relieving chemicals in the body.
Massage therapy
Massages are performed by trained therapists using different techniques, including stretching, kneading, and percussion. This is believed to relieve tension, increase blood flow, and relax your muscles.
Chiropractic therapy
Chiropractors manually adjust the joints in the spine to relieve pressure.
Tai Chi
Tai Chi is a martial art that combines deep breathing and relaxation with slow and gentle movements. This is believed to improve flexibility, balance, and strength.
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Reference: 1. U.S. Department of Health and Human Services . Pain Management Best Practices Inter-Agency Task Force Report: Updates, Gaps, Inconsistencies, and Recommendations. Retrieved from U. S. Department of Health and Human Services website: https://www.hhs.gov/ash/advisory-committees/pain/reports/index.html 2. MacVicar J, Borowczyk JM, MacVicar AM, Loughnan BM, Bogduk N. Cervical medial branch radiofrequency neurotomy in New Zealand. Pain Med. 2012 13:647-654. 3. Dreyfuss P, Halbrook B, Pauza K, Joshi A, McLarty J, Bogduk N. Efficacy and validity of radiofrequency neurotomy for chronic lumbar zygapophysial joint pain. Spine. 2000 25:1270-1277. 4. Govind J, King W, Bailey B, Bogduk N. Radiofrequency neurotomy for the treatment of third occipital headache. J Neurol Neurosurg Psychiatry. 2003 74:88-93.
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Lower Back Pain Caused By Infection
Infections of the spine are not common, but they do occur. The doctor will ask about the usual signs and symptoms of infection, especially when back pain is accompanied by fever and/or chills. Dialysis patients, IV drug users, and patients who have recently had surgery, trauma, or skin infections are at risk for infections of the spine. Infections of the spine can be caused by a number of agents, most commonly bacteria. Doctors will first test for the presence of bacteria, then give antibiotics.
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.
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How Do You Know If Its Your Hip Or Sciatica
If you have pain that radiates from your buttock down your leg, it could be sciatica. Sciatica is caused by a pinched nerve in the lower back. The pain from sciatica is often worse when you sit or stand for long periods of time. If the pain is in your hip, it is more likely to be caused by a problem with your hip joint.
The most common type of sciatica is a condition that causes hip pain. As a result, it is also a sign of a completely different problem. By using this handy guide below, you can determine whether your pain is caused by a hip problem or a different one. Other conditions, such as sciatica in the hips, can also cause pain. If you have any of these issues, you may be able to better target treatment. Always seek the advice of a qualified health professional rather than relying on your own instincts. Strengthening and mobility exercises in the hips can help relieve hip arthritis in some cases.
The legs should be stretched to begin with. Walking is very effective for back pain as long as it does not exacerbate your symptoms. This is one of the most common and frequently treated forms of leg pain. If you have sciatica symptoms in your hips, you should always consult a doctor to see if you can get relief. As a substitute for medical advice, it should never be used to diagnose or treat a sciatica condition.
Can I Prevent Lower Back Pain
You cant prevent lower back pain that results from disease or structural problems in the spine. But you can avoid injuries that cause back pain.
To reduce your risk of a back injury, you should:
- Maintain a healthy weight: Excess weight puts pressure on vertebrae and disks.
- Strengthen your abdominal muscles: Pilates and other exercise programs strengthen core muscles that support the spine.
- Lift the right way: To avoid injuries, lift with your legs . Hold heavy items close to your body. Try not to twist your torso while youre lifting.
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Sharp Lower Left Back Pain From A Herniated Disc
A herniated disc develops when a disc protrusion ruptures or herniates through the fragile intervertebral disc wall. As a result, the viscous material from the interior of the disc can spill into the spinal canal, generating mid to severe pain from impingement on sensitive nerves. Disc herniation usually originates from gradual, age-related wear and tear referred to as disc degeneration. Common symptoms of herniated discs depend on the location in the spine and if the disc is pressing on a nerve. The most common symptoms a patient will experience include pain in the buttocks, thigh, and calf, numbness or tingling from the affected nerves, and muscle weakness affecting stability and the ability to lift or hold items.
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.
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