Lower Back Pain And Cancer
Cancer involving the lumbar spine is not a common cause of back pain. 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 .
How Your Back Works
The spine, which is also called the backbone or spinal column, is one of the strongest parts of the body and gives us a great deal of flexibility and strength.
Its made up of 24 bones, known as vertebrae, one sitting on top of the other. These bones have discs in between and lots of strong ligaments and muscles around them for support. There are also the bones in the tailbone at the bottom of the back, which are fused together and have no discs in between.
On either side of the spine, running from top to bottom, are many small joints called the facet joints.
The spinal cord passes inside the vertebrae, which protect it.
The spinal cord connects to the brain through the base of the skull and to the rest of the body by nerves that pass through spaces between the bones of the spine. These nerves are also known as nerve roots.
As you grow older, the structures of your spine, such as the joints, discs and ligaments, age as well. The structures remain strong but its usual for your back to get stiffer as you get older.
Why Is Lower Back Pain Such A Common Problem
The bottom part of your back typically has just five vertebrae fewer than your neck and mid-back. And these vertebrae do a lot of heavy lifting! Your lower back is where your spine connects to your pelvis, bearing the weight of your upper body. This area experiences a lot of movement and stress, which may lead to wear, tear and injuries.
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How Is A Herniated Disc/pinched Nerve Treated
The treatment for the vast majority of people with a herniated disc does not normally include surgery. Many patients will respond to non-surgical treatments. The primary element of non-surgical treatment is controlled physical activity. Usually, treatment will begin with avoidance of exacerbating activities followed by a gradual return to normal activities. Sitting is bad for this condition because the sitting posture puts a large amount of stress and pressure on the lumbar spine, which may increase the pressure on the affected nerve root. The appropriate use of medications is an important part of non-surgical treatment. This can include anti-inflammatory drugs, analgesics, muscle relaxants, or tranquilizers. Physical therapy is also important.
Surgical treatment and chronic pain therapies are reserved for people who have not had success with non-surgical treatment options and a sufficient period of time has passed to indicate that they may need to have surgery in order to help them to get better.
Dietary And Lifestyle Modifications
As most nutrients are absorbed higher up in the digestive tract, persons with ulcerative proctitis generally do not have nutrient deficiencies however, other factors may influence an individuals nutritional state. Disease symptoms may cause food avoidance, leading to food choices that might not provide a balanced diet. If bleeding is excessive, then modifications to the diet will be necessary to compensate for this.
Better overall nutrition provides the body with the means to heal itself. It is important to follow Canadas FoodGuide, but some foods may irritate the rectum and increase symptoms, even though they do not affect the disease course. The customized recommendations of a registered dietitian can address your sensitive digestive tract.
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How To Tell The Difference
If you have leg pain without significant back pain, it can be hard to tell if the problem is your back or your hip. Vinita Mathew, MD, FAAPMR, is a physical medicine and rehabilitation specialist at Northwestern Medicine Integrated Spine Center. Here, Dr. Mathew explains what to look for and what to expect if you see your physician for leg pain.
You’ve Been In Pain For Over A Week
Most back pain will subside after a few days, but if you’ve been experiencing pain for over a week, then it’s time to call a doctor. Your doctor will perform any examinations or tests required to help get to the bottom of your pain before it could become a bigger problem. As is the case with many health conditions, prevention and addressing problems early is key.
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Chronic Exertional Compartment Syndrome
Chronic exertional compartment syndrome is when a specific group of muscles, called a compartment, swells during exertion. This leads to an increase in pressure within the compartment, which decreases blood flow and leads to pain.
CECS most often affects people who do activities with repetitive leg motions, like fast walking, running, or swimming.
If you have CECS, you may experience pain in your calves during physical activity. The pain typically goes away when the activity stops. Other symptoms may include:
- muscle bulging
- trouble moving your foot
CECS usually isnt serious, and the pain goes away when you rest. You can help prevent CECS by avoiding the types of activities that cause pain.
Make an appointment with your doctor if you have calf pain when walking that:
- doesnt improve or gets worse with a few days of at-home care
- makes moving around or performing daily activities difficult
- affects your range of movement
Seek prompt medical attention if you notice:
- swelling in one or both legs
- a leg thats unusually pale or cool to the touch
- calf pain that occurs after a long period of sitting, such as after a long plane trip or car ride
- signs of infection, including fever, redness, and tenderness
- any leg symptoms that develop suddenly and cant be explained by a specific event or condition
The Healthline FindCare tool can provide options in your area if you dont already have a doctor.
Diagnostic Tests/lab Tests/lab Values
The diagnosis of Crohns disease is made by ruling out other potential causes to explain the patients signs and symptoms. Some of the tests include blood tests, fecal occult blood test , colonoscopy, flexible sigmoidoscopy, barium enema or small bowel imaging, CT of the GI tract, or a capsule endoscopy.
The blood tests are used to check for anemia which would indicate inflammation within the body, infection, and antibodies that might be present with individuals with inflammatory bowel disease.
The FOBT assesses an individuals stool sample for the presence of blood.
A colonoscopy allows the doctor to take a biopsy or tissue sample to determine if there is a presence of any granulomas which are common with Crohns disease and not ulcerative colitis.
The flexible sigmoidoscopy allows the doctor to assess the last portion of the colon for any biopsy samples. This allows the doctor to determine if there is any inflammation or bleeding amongst the intestines.
Barium enemas allow the doctors to assess the intestines via x-ray. The barium coats the inner lining of the GI tract to allow the lining to be visible on the x-ray.
A CT of the GI tract allows a quick look at the entire bowel in a way that cannot be seen in other diagnostic tests. This helps to assess for blockages, abscesses or fistulas.
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Accurate Diagnosis Is Key
If your physician examines your hip joint and notes no hip pain, and then examines your back and notes leg pain, the spine is usually the source of the problem. Some people may have localized hip pain without leg pain, but are found to have a normal hip and an abnormal spine. Others may have only leg pain, but are found to have an abnormal hip and a normal spine. Therefore, in addition to a good physical examination, imaging is important. Plain X-rays may be helpful, but sometimes an MRI is needed as well. If imaging does not determine the source of the pain, the next step would typically be to perform an injection of pain-relieving medication directly into the area suspected of causing pain. Whether you get pain relief from the injection can help your physician better understand where the pain is coming from.
How Can I Tell If Pain In My Hip Is A Hip Issue Or Sciatica
Hip problems, such as arthritis in the hip, usually cause groin pain, pain when you put weight on your leg, or when the leg is moved around.
If your pain starts in the back and moves or radiates towards the hip or down the leg and you have numbness, tingling or weakness in the leg, sciatica is the most likely cause.
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Clarify What The Numbers On The Pain Scale Mean For You
Youre probably familiar with the scale medical professionals use to assess pain. You simply rate your pain from 0 to 10, with 0 being no pain at all and 10 being the worst possible pain.
As plenty of doctors and nurses themselves have pointed out, this scale has potential for misunderstandings and bias to creep in. As a person with a uterus, Ive always felt that medical professionals disregard my claims about pain because Ive never experienced childbirth so what would I know about Real Pain?
Of course, everyone experiences childbirth and other painful things differently, and you cant really compare. But thats a comment Ive heard both from medical professionals and laypeople for my entire adulthood so far.
If your doctor uses the pain scale, give them some context on what you mean when you use it to describe what youre feeling.
Tell them what the worst pain youve ever felt is, and how youre comparing this to that. Explain to them that youre not necessarily looking for a 0 tell them your threshold for being able to cope with pain on your own, without medication, or with Tylenol or ibuprofen only.
For instance, when I say 5, I usually mean that its there and its distracting, but its not totally unmanageable. When I say 6, I definitely need some sort of medication. But for me to be able to function more-or-less normally, it would have to be 4 or less.
Risk Factors For Sciatica
Most people aged between 30 to 50 years old are at a higher risk of getting sciatica.
Weight
Obese people have increased risk since the extra weight puts pressure on your lumbar spine, increasing the tendency of getting a herniated disk that will compress the sciatic nerve.
Diabetes
Diabetic people have increased risk since the disease causes sciatic nerve damage.
Occupation
Some jobs put people at more risk of getting sciatica, especially those involving a lot of heavy lifting or sitting for prolonged periods. These may cause disc damage in the lumbar region.
Genetics
Studies show that genetics play a big part in the development of sciatica by causing intervertebral disc degeneration.
Some gene mutations may change the structure and function of collagen proteins that are part of the intervertebral discs. This results in weakened discs that degenerate, which leads to irritation of the sciatic nerve.
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Symptoms Of Sciatica Leg Pain And Lower Back Pain
- Lower back pain
- Tingling in the legs
- Weakness in your leg muscles
While sciatica can cause pain to radiate from your lower back all the way to your big toe, it may also be isolated to just a portion of that area. Symptoms may range from leg pain and lower back pain to an isolated pain in your buttock or an ache or numbness in your big toe. So, I get people that come in with numbness in their big toe and think there is a problem with their toe, but its actually a problem with interference of the sciatic nerve coming out of the lower back that has caused their big toe to be numb.
Causes Of Leg Pain And Foot Pain
Leg pain and foot pain vary in type and severity and typically depend on a persons lifestyle and associated medical problems.1 In addition to leg pathology, leg pain may be caused by a condition affecting the lower back, hip, or pelvic region. The type of pain may differ based on the underlying cause.
Some conditions in the lower back can cause pain and other symptoms to radiate into the leg and/or foot, which may be termed as sciatica. WatchSciatica Causes and Symptoms Video
This article provides a guide to the potential causes, specific diagnostic procedures, and the different types of treatment approaches available for leg and foot pain.
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When Should I Be Worried About My Childs Back Pain
If your childs pain lasts longer than 4-6 weeks, is getting worse, or is accompanied by unusual features such as a persistent high temperature or numbness, they may be referred to a specialist. If there is a serious cause, it is usually important to start treatment as soon as possible.
When should I be concerned about back and leg pain?
If your lower back pain is accompanied by other troubling symptoms, it may require immediate medical attention. Seek immediate medical care if your lower back pain is experienced in tandem with any of the following symptoms: Increasing weakness in your legs. Loss of bladder and/or bowel control.
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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Signs You Might Need Surgery
Most people with sciatica don’t need surgery. But your doctor may suggest it if you have trouble walking, lose control of your bladder or bowels, or your pain gets worse and other treatments don’t help. The best procedure depends on what’s causing your symptoms. The most common one removes the part of your herniated disk that’s pressing on the sciatic nerve. Learn more about sciatica and the radiculopathy lumbar region.
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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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Types Of Leg Pain That Are Actually Caused By A Back Problem
No doubt about it, your legs endure a lot of stress throughout your life, leading to a general wear and tear that may result in pain. However, not all sources of leg pain are caused by issues related to the joints, muscles, ligaments, tendons, or cartilage that make up your lower extremities.
Its possible that the electric shock sensation you feel shooting down your leg every time you reposition your body is due to a back problem. At Texas Spine Consultants in Addison and Plano, Texas, our orthopedic surgeons specialize in spine health and help many people get relief from their leg pain by treating the underlying back problem responsible for the traveling pain sensations.
To save you from unnecessary testing and treatment of your legs, we want to share with you the types of leg pain that are actually caused by a back problem.