For Your Convenience We’ve Divided These Causes Into Five Categories As Follows
- Low risk: This can be easily managed with over-the-counter medications or by avoiding the movement/stressor causing your pain.
- Low-medium risk: Usually managed as an outpatient by your doctor with prescription medication.
- Medium risk: May require a visit to your doctor or hospitalization. Prescription medication may be necessary.
- Medium-high risk: Hospitalization or urgent intervention. Although not life-threatening get help immediately of some kind.
- High risk: Serious and potentially lethal complications possible emergent intervention needed Intensive Care Unit care often needed.
Iliac Crest Apophysis Avulsion
Avulsion fractures of the apophyses of the pelvis are rare injuries. This injury occurs mainly in young persons, between the ages of 8 and 14, before they’ve fully grown. That is because fusion of these bones does not occur until between the ages of 15 and 17 years. The cause is typically a contraction of muscles during extreme sports activity. Treatment includes rest and physical therapy as well as pain medications.
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.
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Pain From Herniated Discs
Spinal discs act as shock absorbers and cushions between the vertebrae, protecting us against the wear-and-tear caused by everyday activities, as well as aging. A sudden and severe shooting pain in the back is a common symptom of a slipped disc.
A slipped disc occurs when the softer interior of a disc leaks out due to a rupture in the exterior of the disc, and this leakage can irritate the nerves and cause pain, numbness, or weakness.
When & How To Seek Medical Care
If low back pain lasts for longer than one to two weeks, seek medical care. First, make an appointment with your primary care physician.
Seek immediate medical attention if any of the following symptoms are present in addition to back pain:
- Severe abdominal pain
- Unexplained fever
- Loss of control of your bowels or bladder
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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.
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.
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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.
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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When Should You Seek Treatment For Acute Or Chronic Back Pain
Whether you think your back pain is acute or chronic, anytime youre experiencing pain that lasts longer than two weeks without any improvement in symptoms, we strongly suggest you get the care you need.
If you think you need care right away, you can also go to your nearest orthopedic urgent care location.
If the pain is new or you know youve tweaked something, a great place to start is to find a physical therapy location and make an appointment. Our physical therapists will tailor strengthening and mobility exercises to your unique needs, and you can plan on about six visits.
That said, acute back pain will usually heal itself over a few weeks. But chronic pain usually doesnt get better without medical intervention. Why? While home remedies and short-term back pain treatments are helpful, they provide temporary relief and dont address those underlying causes of chronic pain.
So, if youre regularly experiencing signs of chronic back pain, dont ignore it. While chronic pain is long-lasting, it doesnt have to be permanent and you probably dont need surgery. This is where the Physicians Neck & Back Center spinal strengthening program can help.
Muscle Strain Or Sciatica
Muscle strain is often the cause of back pain from heavy lifting or vigorous exercise. But sometimes itâs due to small jelly-filled disks meant to protect the space between vertebrae. When one of these disks bulges or breaks, it can push on a nerve. When itâs the sciatic nerve, pain runs from the buttock down one leg. This is sciatica.
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What Are Some Complementary Alternative And Emerging Treatments For Lower Back Pain
In some cases, doctors suggest therapies that are not considered standard of care. They probably wont be covered by insurance, but they may be worth considering. Examples include:
Platelet-rich plasma . PRP treatments use a small sample of your own blood that has concentrated amounts of blood building blocks known as platelets. Your doctor then injects the PRP directly into a damaged disc. The theory is that PRP injections use your own healing system to accelerate improvement of injured tendons, ligaments, muscles, and joints. PRP treatment has a longer track record in knee osteoarthritis, but a recent review article in the Journal of Spine Surgery suggests it may have a useful role for back pain, too. PRP needs a lot more research before it can be considered a proven technique.
Stem cells. In this emerging treatment, your doctor injects stem cells harvested from your hip into the intervertebral disc or discs causing your pain. Doing so may lessen pain and the degenerative effects of aging, though, like PRP, more research is needed before stem cells for lower back pain could eventually become the standard of care.
Acupuncture. Your doctor probably doesnt perform acupuncture , but may support you trying it as a complementary therapy. Acupuncture involves careful insertion of fine, sterile needles into specific points on your body. This may stimulate the release of your natural pain-killing chemicals.
Is Lower Right Back Pain Serious
Lower right back pain can vary in severity. You will probably have the best idea of your pain level and when you should see a physician.
- Not serious: Mild pain may come on fairly suddenly after exercise and responds to rest and over-the-counter pain relievers.
- Moderately serious: In some cases, an injury that at first seems minor can become worse over time. Back injuries can easily become chronic if not treated quickly.
- Serious: If your back pain interferes with your normal activities and is becoming severe, you should see a physician as soon as possible.
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What Are The Risk Factors For Developing Low Back Pain
Anyone can have back pain. Factors that can increase the risk for low back pain include:
Age: The first attack of low back pain typically occurs between the ages of 30 and 50, and back pain becomes more common with advancing age. Loss of bone strength from osteoporosis can lead to fractures, and at the same time, muscle elasticity and tone decrease. The intervertebral discs begin to lose fluid and flexibility with age, which decreases their ability to cushion the vertebrae. The risk of spinal stenosis also increases with age.
Fitness level: Back pain is more common among people who are not physically fit. Weak back and abdominal muscles may not properly support the spine. Weekend warriorspeople who go out and exercise a lot after being inactive all weekare more likely to suffer painful back injuries than people who make moderate physical activity a daily habit. Studies show that low-impact aerobic exercise can help maintain the integrity of intervertebral discs.
Weight gain: Being overweight, obese, or quickly gaining significant amounts of weight can put stress on the back and lead to low back pain.
Genetics: Some causes of back pain, such as ankylosing spondylitis , have a genetic component.
Smoking: It can restrict blood flow and oxygen to the discs, causing them to degenerate faster.
Backpack overload in children: A backpack overloaded with schoolbooks and supplies can strain the back and cause muscle fatigue.
Is It Sciatica Pain
Sciatica happens when the sciatic nerve in your spine becomes irritated and causes pain. Because this extra-long nerve extends down your legs, it can cause pain anywhere from the lower back to the toes. Pain can be mild or severe.
Its typically a symptom of something else. A herniated disc, for example, can cause sciatic nerve compression or inflammation. Its also one of the most common reasons for this type of radiating nerve pain. Other conditions that may cause sciatica include:
- Degenerative disc disease
- Blood tests
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What Can Cause Lower Back Pain
Most acute low back pain is mechanical in nature, meaning that there is a disruption in the way the components of the back fit together and move. Some examples of mechanical causes of low back pain include:
Congenital
- Skeletal irregularities such as scoliosis , lordosis , kyphosis , and other congenital anomalies of the spine.
- Spina bifida which involves the incomplete development of the spinal cord and/or its protective covering and can cause problems involving malformation of vertebrae and abnormal sensations and even paralysis.
Injuries
- Sprains , strains , and spasms
- Traumatic Injury such as from playing sports, car accidents, or a fall that can injure tendons, ligaments, or muscle causing the pain, as well as compress the spine and cause discs to rupture or herniate.
Degenerative problems
- Intervertebral disc degeneration which occurs when the usually rubbery discs wear down as a normal process of aging and lose their cushioning ability.
- Spondylosis the general degeneration of the spine associated with normal wear and tear that occurs in the joints, discs, and bones of the spine as people get older.
- Arthritis or other inflammatory disease in the spine, including osteoarthritis and rheumatoid arthritis as well as spondylitis, an inflammation of the vertebrae.
Nerve and spinal cord problems
Non-spine sources
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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Mononeuropathies Of The Leg
Mononeuropathies can affect nerves in the legs, arms, or other parts of the body. Mononeuropathy means a single nerve or nerve group has been damaged, for example, by a lesion that has developed along a nerve or group of nerves. Carpal tunnel syndrome is a good example of a mononeuropathy, in this case, affecting the wrist area. With mononeuropathy symptoms may be sudden or may develop slowly . Some of the more common mononeuropathies are
- femoral neuropathy
- sciatic nerve dysfunction
- peroneal neuropathy .
- tibial neuropathy .
Symptoms of the neuropathies above would include burning sensation in leg areas where these nerves are housed as well as lack of coordination of these leg muscles. Other symptoms include muscle wasting, pain, and twitching, cramps, and spasms in these nerves. Treatment focuses on isolating the underlying cause of the nerve disorder and addressing it using medications such as injected glucocorticoids and/or physical
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:
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Back Muscle Or Spinal Issues
According to the National Institute of Neurological Disorders and Stroke , 80 percent of adults in the United States will experience low back pain at some point in their lives. Much of that pain is caused by mechanical problems, such as:
- overstretching or tearing of a ligament due to improper lifting
- degeneration of a shock-absorbing spinal disc due to aging or normal wear and tear
- muscle tightness due to improper posture
Treatment varies depending on the cause and severity of your condition. Your doctor may initially recommend more conservative options like physical therapy or medications to reduce inflammation. If conservative treatment methods dont help, or if your condition is severe, your doctor may recommend surgery.
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.
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.
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