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What Can Severe Lower Back Pain Mean

How Long Does Lower Back Pain Usually Last

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Lower back pain can be categorized as acute, subacute or chronic. Acute episodes of lower back pain usually last from a few days to 4 weeks and subacute lower back pain lasts between 4 to 12 weeks. However, according to the National Institutes of Health, about 20 percent of people with acute back pain go on to develop chronic back paindefined as pain that lasts 12 weeks or longer. Even in these cases, there are many different treatment options to help relieve lower back pain symptoms.

When your back is really killing you, you might worry something is seriously wrong. The same goes for back pain that seems unending. The good news is that while back pain is a major inconvenience, it is rarely an urgent medical issue. In fact, most of the time you dont have to treat it. Back pain usually resolves on its own unless you have a major underlying issue.

Diagnosing Cancer And Back Pain

A doctor will consider your symptoms and medical history when diagnosing potential lower back pain causes. Its important to include if you have a history of cancer or a family history of cancer.

Because cancer is a rare cause of lower back pain in those who dont already have cancer, a doctor may recommend other treatments before doing a full cancer work-up.

However, if pain persists after physical therapy or anti-inflammatory medications, a doctor may order imaging studies and blood testing. These tests can help identify if there are potential cancer markers that are causing the lower back pain.

The Universal Guide To Lower Back Pain: Everything You Ever Wanted To Know Straight From The Experts

In This Article: Lower Back Anatomy | How Long Does Lower Back Pain Usually Last? | Common Causes | Other Causes | Home Remedies | Nonsurgical Treatments | Complementary, Alternative, and Emerging Treatments | Surgery | When Is Lower Back Pain an Emergency? | Lower Back Pain Prevention |

If youve ever had lower back pain stop you from doing what you want, youre not alone. Lower back pain is one of the most common medical problems in the world. It is a leading reason why people visit a doctor, affecting more than 80% of adults at some point in their lives. According to the Global Burden of Diseasea significant study published in the Lancet medical journallower back pain is also a leading cause of disability.

While severe lower back pain can cause worry, pain severity is not always an indication something is seriously wrong. Photo Source: Shutterstock.

You may not be able to prevent lower back pain, especially as you age and your back loses some strength and resilience. Fortunately, there are many ways you can get relief, no matter the cause of your back pain.

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Ii What Are The Causes Of Lower Back Pain

The vast majority of patients experience back pain because of mechanical reasons. They strain a muscle from heavy lifting or twisting, suffer a sudden jolt in a car accident, experience stress on spinal bones and tissues resulting in a herniated disc, or suffer from osteoarthritis, a potentially painful degeneration of one or more joints. Common causes for low back pain are as follows:

  • Mechanical or Functional Injury
  • Inflammation
  • Neoplastic
  • Referred Pain

To choose the safest and most effective therapy, doctors need to consider the full spectrum of possible underlying issues, such as inflammatory conditions, fracture, infection, as well as some serious conditions unrelated to the back that radiate pain to the back.

Causes Of Chronic Lower Back Pain

Causes of Back Pain: What Causes Back Pain?

Pain is considered chronic once it lasts for more than three months and exceeds the bodys natural healing process. Chronic pain in the low back often involves a disc problem, a joint problem, and/or an irritated nerve root. Common causes include:

Lumbar herniated disc. The jelly-like center of a lumbar disc can break through the tough outer layer and irritate a nearby nerve root. The herniated portion of the disc is full of proteins that cause inflammation when they reach a nerve root, and inflammation, as well as nerve compression, cause nerve root pain. The disc wall is also richly supplied by nerve fibers, and a tear through the wall can cause severe pain.

Degenerative disc disease. At birth, intervertebral discs are full of water and at their healthiest. As people age over time, discs lose hydration and wear down. As the disc loses hydration, it cannot resist forces as well, and transfers force to the disc wall that may develop tears and cause pain or weakening that can lead to a herniation. The disc can also collapse and contribute to stenosis.

See Lumbar Degenerative Disc Disease

Facet joint dysfunction. There are two facet joints behind each disc at each motion segment in the lumbar spine. These joints have cartilage between the bones and are surrounded by a capsular ligament, which is richly innervated by nerves. These joints can be painful by themselves, or in conjunction with disc pain.

See Lumbar Spinal Stenosis

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You Have Unexplained Weight Loss

If you experience sudden weight loss that can’t be explained by diet and lifestyle changes, then you should always pay attention to what your body is telling you. This is especially true when the unexplained weight loss is accompanied by back pain. See your doctor to rule out the possibility of a more severe condition, such as an infection or tumor.

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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I How Common Is Lower Back Pain

Two out of every three adults suffer from low back pain at some time. Back pain is the No. 2 reason adults visit a doctor and the No. 1 reason for orthopedic visits. It keeps people home from work and interferes with routine daily activities, recreation, and exercise. The good news is that for 9 out of 10 patients with low back pain, the pain is acute, meaning it is short-term and goes away within a few days or weeks. There are cases of low back pain, however, that take much longer to improve, and some that need evaluation for a possible cause other than muscle strain or arthritis.

Symptoms may range from muscle ache to shooting or stabbing pain, limited flexibility and/or range of motion, or an inability to stand straight.

What Structures Make Up the Back?

Starting at the top, the spine has four regions:

  • The seven cervical or neck vertebrae
  • The 12 thoracic or upper back vertebrae
  • The five lumbar vertebrae , which we know as the lower back, and
  • The sacrum and coccyx, a group of bones fused together at the base of the spine.

Image courtesy of www.SpineUniverse.com

How Is Back Pain Diagnosed

Severe Lower Back Pain & Radiculopathy-Degenerative Disc Disease-Herniated L Disc Miami Florida Man

Most people who develop low back pain that comes on suddenly have nonspecific low back pain. If there are no other associated symptoms and the pain is not too bad, many people are confident to just ‘get on with it’ and treat it themselves – and indeed most get better quickly. However, if in doubt, see your doctor for a check-over and advice.

A doctor will usually want to ask questions about your symptoms and to examine you. Basically, the symptoms are usually as described above, with no other worrying symptoms to suggest anything serious or another cause of back pain . The examination by a doctor will not detect anything to suggest a more serious cause of back pain. Therefore, a doctor can usually be confident from his or her assessment that you have nonspecific back pain.

As a general guide, if any of the following occur then it may not be nonspecific low back pain, and there may be a more serious underlying cause. But note: the vast majority of people with low back pain do not have any of the following symptoms or features. They are included here for completeness and as an aid to what to look out for and to tell your doctor should they occur.

  • Symptoms that may indicate cauda equina syndrome. The main ones are, in addition to back pain:
  • Numbness around the back passage – the saddle area.
  • Bladder symptoms such as loss of bladder sensation loss of bladder control, incontinence, loss of sensation when passing urine.
  • Incontinence of stools .
  • If you inject street drugs.
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    Muscle Strain And Ligament Sprain

    A low back sprain or strain can happen suddenly, or can develop slowly over time from repetitive movements.

    • Strains occur when a muscle is stretched too far and tears, damaging the muscle itself.
    • Sprains happen when over-stretching and tearing affects ligaments, which connect the bones together.

    For practical purposes, it does not matter whether the muscle or ligament is damaged, as the symptoms and treatment are the same.

    Common causes of sprain and strain include:

    • Lifting a heavy object, or twisting the spine while lifting
    • Sudden movements that place too much stress on the low back, such as a fall
    • Poor posture over time
    • Sports injuries, especially in sports that involve twisting or large forces of impact

    While sprains and strains do not sound serious and do not typically cause long-lasting pain, the acute pain can be quite severe.

    What Causes Degenerative Discs And Herniated Discs

    Why is the lower back a target area for pain? “Generally speaking, the lower back is subject to a lot of mechanical stress and strain,â says Gunnar Andersson, MD, PhD, professor and chairman emeritus of the Department of Orthopedic Surgery at Rush University Medical Center in Chicago. âThe reason is the weight of the upper body, which always puts loads on the lower back.”

    Supporting all that upper body weight is the spine, which is made up of more than 30 small bones called vertebrae stacked one on top of the other. A spongy piece of cartilage, called a disc, sits between each vertebra. It acts as a shock absorber, preventing the bony vertebrae from grinding against one another.

    With age, these cushioning discs gradually wear away and shrink, a condition known as degenerative disc disease. Discs can also tear or become injured. Sometimes the weakening of a disc can put pressure on its jelly-like center. Wisneski describes this process as similar to a bubble forming on your car’s tire.

    “You hit a bump in the road, then all of a sudden that tire goes pop,” he says. In the case of your back, that pressure can lead to a herniated disc , in which the center of the disc bulges.

    A herniated disc in the lower back can put pressure on the nerve that extends down the spinal column. This commonly causes pain to radiate to the buttocks and all the way down the leg. This condition is called sciatica.

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    Understanding The Lower Back

    The lower back is also called the lumbosacral area of the back. It is the part of the back between the bottom of the ribs and the top of the legs.

    Most of the lower back is made up from muscles that attach to, and surround, the spine. The spine is made up of many bones called vertebrae. The vertebrae are roughly circular and between each vertebra is a disc. The discs between the vertebrae are a combination of a strong fibrous outer layer and a softer, gel-like centre. The discs act as shock absorbers and allow the spine to be flexible.

    Your Pain Extends To Other Body Parts

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    If you’re experiencing severe back pain that is coupled with pain in other areas such as shooting pain down your leg then you should see a doctor. This could be a sign that you have sciatica, a form of pain that affects the sciatic nerve, which runs from the lower back and through the buttocks before branching down each leg. This condition usually results from a herniated disk. A doctor will be able to offer a variety of ways that you can relieve this pain.

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    How Is Back Pain Treated

    Acute back pain usually gets better on its own. Acute back pain is usually treated with:

    • Medications designed to relieve pain and/or inflammation
    • analgesics such as acetaminophen and aspirin
    • non-steroidal anti-inflammatory drugs such as ibuprofen and naproxen may be sold over the counter some NSAIDS are prescribed by a physician
    • muscle relaxants are prescription drugs that are used on a short-term basis to relax tight muscles
    • topical pain relief such as creams, gels, patches, or sprays applied to the skin stimulate the nerves in the skin to provide feelings of warmth or cold in order to dull the sensation of pain. Common topical medications include capsaicin and lidocaine.
  • Heat and/or ice may help ease pain, reduce inflammation, and improve mobility for some people
  • Gentle stretching upon advice by your healthcare professional
  • Exercising, bed rest, and surgery are typically not recommended for acute back pain.Chronic back pain is most often treated with a stepped care approach, moving from simple low-cost treatments to more aggressive approaches. Specific treatments may depend on the identified cause of the back pain.

    Treatments For Back Pain From A Specialist

    A GP, specialist or physiotherapist may recommend extra treatments if they do not think your pain will improve with self-help measures alone.

    These may include:

    • group exercise classes where you’re taught exercises to strengthen your muscles and improve your posture
    • manual therapy treatments, such as manipulating the spine and massage, which are usually done by a physiotherapist, chiropractor or osteopath
    • psychological support, such as cognitive behavioural therapy , which can be a useful part of treatment if you’re struggling to cope with pain

    Some people choose to see a therapist for manual therapy without seeing a GP first. If you want to do this, you’ll usually need to pay for private treatment.

    Surgery is generally only considered in the small number of cases where back pain is caused by a specific medical condition.

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    Low Back Pain Treatment

    Epidural Steroid Injection

    Epidural steroid injections are most commonly used in situations of radicular pain, which is a radiating pain that is transmitted away from the spine by an irritated spinal nerve. Irritation of a spinal nerve in the low back causes pain that goes down the leg. Epidural injections are also used to treat nerve compression in the neck , referred to as cervical radiculopathy, which causes pain.

    When To Seek Medical Care For Back Pain

    Severe Low Back Pain, Sacroiliac Pain, Sciatica First Time Adjustment

    The Agency for Healthcare Research and Quality has identified 11 red flagsthat doctors look for when evaluating a person with back pain. The focus of these red flags is to detect fractures , infections, or tumors of the spine. Presence of any of the following red flags associated with low back pain should prompt a visit to your doctor as soon as possible for complete evaluation.

    • Recent significant trauma such as a fall from a height, motor vehicle accident, or similar incident
    • Recent mild trauma in those older than 50 years of age: A fall down a few steps or slipping and landing on the buttocks may be considered mild trauma.
    • History of prolonged steroid use: People with asthma, COPD, and rheumatic disorders, for example, may be given this type of medication.
    • Anyone with a history of osteoporosis: An elderly woman with a history of a hip fracture, for example, would be considered high risk.
    • Any person older than 70 years of age: There is an increased incidence of cancer, infections, and abdominal causes of the pain.
    • Prior history of cancer
    • Unexplained weight loss

    The presence of any of the above would justify a visit to a hospital’s emergency department, particularly if your family doctor is unable to evaluate you within the next 24 hours.

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    When Is Lower Back Pain An Emergency

    Most episodes of lower back pain eventually resolve on their own, but there are times when you should seek urgent medical attention. Some of these situations include:

    • Patient is a child
    • Pain is severe, constant, suddenly or progressively worsens, and/or doesnt go away
    • Pain interrupts sleep

    While some situations may warrant immediate intervention, most cases are not urgent and can be scheduled at a time convenient for the patient.

    What Is The Function Of The Low Back

    The low back, or lumbar area, serves a number of important functions for the human body. These functions include structural support, movement, and protection of certain body tissues.

    When we stand, the lower back is functioning to support the weight of the upper body. When we bend, extend, or rotate at the waist, the lower back is involved in the movement. Therefore, injury to the structures important for weight bearing, such as the bony spine, muscles, tendons, and ligaments, often can be detected when the body is standing erect or used in various movements.

    Protecting the soft tissues of the nervous system and spinal cord as well as nearby organs of the pelvis and abdomen is a critical function the lumbar spine and adjacent muscles of the low back.

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