Chronic Low Back Pain Is Serious But Rarely Ominous
Back pain can suck the joy out of your days for week, months, even years. It can definitely be serious even when its not dangerous. I have worked with many truly miserable chronic low back pain patients, and of course the huge economic costs of back pain are cited practically anywhere the subject comes up. But your typical case of chronic low back pain, as nasty as it can be, has never killed anyone.
Ominous is medical jargon for truly scary. Cue Jaws theme music. Low back pain is ominous when it is caused by something that can cripple or kill you. Such causes are rare, fortunately. But awful things do happen, even the best doctors can miss them .
Ordinary back pain can be fierce & awful but not dangerous. Its bark is almost always much louder than its bite.
Facet Joint Pain And Spinal Arthritis
Facet joints are interconnecting joints located at the back of the spine collectively, they give the spine its integrity by limiting excessive movement. Each spinal level has a right and left facet joint. Facet joints are also known as zygapophysial joints.
Facet joints are often the site where bone spurs and other arthritic changes occur. Such changes tend to be related to wear and tear, and at any given level, may occur on one facet joint, but not the others. So when they develop on the right side, they may cause right side back pain.
Other symptoms include numbness, tingling, electrical sensations and/or weakness that travel down one extremity.
The Big Three Signs That You Should Investigate For An Ominous Cause Of Persistent Low Back Pain
You shouldnt worry about low back pain until three conditions have been met:
The presence of the big three does not confirm that something horrible is going on. It only means that you need to check carefully.
Andy Whitfield as Spartacus
At his physical peak, not long before getting sick. The first sign of his cancer was steadily worsening back pain. He may have already been in pain at this time.
The story of actor Andy Whitfield is a disturbing and educational example of a case that met these conditions for sure the first two, and probably the third as well if we knew the details. Whitfield was the star of the hit TV show Spartacus . The first sign of the cancer that killed him in 2011 was steadily worsening back pain. Its always hard to diagnose a cancer that starts this way, but Whitfield was in the middle of intense physical training to look the part of historys most famous gladiator. Back pain didnt seem unusual at first, and some other symptoms may have been obscured. Weight loss could have even seemed like a training victory at first! It was many long months before he was diagnosed not until the back pain was severe and constant. A scan finally revealed a large tumour pressing against his spine.
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What Are The Symptoms Of Lower Back Pain
Symptoms of lower back pain can come on suddenly or appear gradually. Sometimes, pain occurs after a specific event, such as bending to pick something up. Other times, you may not know what caused the pain.
Pain may be sharp or dull and achy, and it may radiate to your bottom or down the back of your legs . If you strain your back during an activity, you may hear a pop when it happened. Pain is often worse in certain positions and gets better when you lie down.
Other symptoms of lower back pain include:
- Stiffness: It may be tough to move or straighten your back. Getting up from a seated position may take a while, and you might feel like you need to walk or stretch to loosen up. You may notice decreased range of motion.
- Posture problems: Many people with back pain find it hard to stand up straight. You may stand crooked or bent, with your torso off to the side rather than aligned with your spine. Your lower back may look flat instead of curved.
- Muscle spasms: After a strain, muscles in the lower back can spasm or contract uncontrollably. Muscle spasms can cause extreme pain and make it difficult or impossible to stand, walk or move.
Is Lower Right Or Left Back Pain Worrisome
Pain on one side of the back is not particularly more worrisome than central pain. There are three main kinds of one-sided back pain:
Most of the anatomy of the low back and abdomen is symmetrical. Some of the guts are not symmetrical, and only some of those is a plausible cause of back pain on one side. Heres some of the key anatomy to consider:
The side of the pain on its own doesnt tell us much, and most of the one-sided sources of pain are viscera that usually cause abdominal pain instead of back pain, or in addition to it. In other words, the only reason to worry about right or left lower back pain is if it is otherwise worrisome: if you have other red flags or significant non-back symptoms.
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Skeletal Disease Or Injury
Skeletal disease or injury affecting the nerves on the right side of the back can lead to pain.
- Cartilage deterioration: This is wearing away of the cartilage at the ends of the bones, due to either age or disease.
- Bony growths: Small overgrowths of bones in the spine may crowd the spinal cord and cause pain and numbness or pinch other nearby structures. A general narrowing of the spinal canal is known as spinal stenosis.
- Scar tissue: This may form due to injury or the result of spinal surgery.
- Injury or disease of the discs: These are the “cushions” between each of the spinal vertebrae. A disc may be partly pushed out of place, causing pressure on a nerve. A disc may also rupture and lose some of its contents, causing pain and pressure on the surrounding nerves .
Protect Your Back While Lifting
Lifting is an usual reason for reduced pain in the back. Usual everyday tasks, such as dumping grocery store bags from the auto or raising your young kid, can cause decrease back troubles.
Raising with your back bent, or lifting while turning, might trigger an abrupt injury to your reduced back or recurring injury over a time period, causing chronic tissue damages.
Bend at your knees, not at your lower back an entirely bent back can be highly vulnerable to a ligament or disc injury.
Pivot your feet and also hips, as opposed to twisting your reduced back.
Hold the item close to your upper body while correcting your spinal column.
While training belongs of daily tasks, having a job that includes heavy lifting might enhance your danger of developing reduced back problems.
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Kidney Stones Or Infection
Your kidneys are part of your urinary tract. Theyre located on either side of your spine, but when they become inflamed or infected, the pain can radiate to the front. When your left kidney is involved, you might feel pain near the left side of your rib cage.
Kidney stones are hardened calcium and salt deposits that form into stones. They can cause a cramping pain as they move out of your kidneys and make their way toward your bladder. In addition to pain in your left rib cage, kidney stones can also cause:
- an urge to urinate, with little coming out
- bloody or cloudy urine
- pain in your side that radiates to the front of your body
Kidney infections occur when bacteria from your urinary tract make their way into your kidneys. Anything that obstructs your flow of urine, including kidney stones, can cause a kidney infection. Additional symptoms of a kidney infection include:
When Should I See My Healthcare Provider About Lower Back Pain
Lower back pain usually gets better with rest and pain relievers. Back pain that doesnt go away may be a sign of a more serious condition.
See your provider if you have:
- Pain that doesnt get better after about a week of at-home care.
- Tingling, numbness, weakness or pain in your buttocks or legs.
- Severe pain or muscle spasms that interfere with your normal activities.
- Fever, weight loss, bowel or bladder problems or other unexplained symptoms.
A note from Cleveland Clinic
Millions of people live with low back pain. Stiffness, pain and limited movement can have a major impact on quality of life. But you may be able to avoid lower back pain by maintaining a healthy weight and staying active. Talk to your provider if back pain doesnt go away or if youre unable to do the activities you enjoy. Several treatments can relieve pain, help you move better and get more out of life.
Last reviewed by a Cleveland Clinic medical professional on 01/18/2021.
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What Are Some Less Invasive Or Noninvasive Back Pain Treatments
Your doctor has a wide range of treatments that may help your lower back pain. In general, expect your doctor to take a stepped care approach. That means starting with simple, low-cost treatments and moving to more aggressive approaches later. Keep in mind that many treatments take time to reach their full effect.
Medications. When over-the-counter pills and topicals dont do enough to relieve back pain, your doctor may recommend a prescription drug. Examples include:
- Antiseizure medication, such gabapentin or pregabalin, for nerve-related pain
- Muscle relaxants, such as baclofen or carisoprodol
- Prescription NSAIDs, such as celecoxib, diclofenac, or fenoprofen
- Opioids, such as oxycodone or hydrocodone, on a short-term basis.
Physical therapy . PT for lower back pain involves passive and active therapies to help the patient build core muscle strength, improve spinal flexibility and range of motion, correct posture and more. Your physical therapy sessions may include:
- Transcutaneous electrical nerve stimulation
How Is Back Pain Diagnosed
The diagnosis of back pain begins with a questionnaire about the patients activities, lifestyle, and medical conditions. As you can see from the list above, multiple factors can cause lower left back pain, so your physician or chiropractor will try to narrow down what could be factors in your situation.
Because chiropractors specialize in the treatment of the back problems, they are often skilled at asking the right questions to get started on the right path. Typical questions include:
- When did the pain begin? What were you doing at the time?
- What makes it feel better or worse?
- What kind of pain is it? Is it sharp and knife-like or dull and throbbing?
- Where is the pain located? Does it radiate anywhere else?
- How severe is the pain? You may be asked to rate it on a scale of 1-10.
- Does the pain come and go, or is it constant?
- What kind of exercise do you do?
- Do you spend a lot of time sitting, standing, driving, etc.?
- What kind of mattress do you use? How is the quality of your sleep?
- Do you have any medical conditions, or are you pregnant?
- What medications or supplements do you take?
- What else might be relevant to your pain?
A physical exam is also important. A chiropractor or other practitioner will want to palpate the area to see if it provokes the pain and where the pain is located. They will want to see if it limits other mobility. They may want to check your vital signs or check for concurrent pain elsewhere, like in your abdomen.
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Herniated Disk In The Lower Back
The backbone, or spine, is made up of 26 bones called vertebrae. In between the bones are soft disks filled with a jelly-like substance. These disks cushion the vertebrae and keep them in place. Although people talk about a slipped disk, nothing actually slips out of place. The outer shell of the disk ruptures, and the jelly-like substance bulges out. It may be pressing on a nerve, which is what causes the pain.A slipped disk is more likely to happen due to strain on the back, such as during heavy lifting, and older individuals are at higher risk.
Top Symptoms: lower back pain, moderate back pain, back pain that shoots down the leg, back pain that gets worse when sitting, leg weakness
Urgency: Primary care doctor
Sensations That Might Indicate A Medical Emergency
1. Sharp pain rather than a dull ache: This could indicate a torn muscle or ligament, or a problem with an internal organ in the back or side.2. Radiating pain: This pain “moves” or shoots to the glutes or legs, which could indicate a nerve compression condition.
3. Sudden weakness in the legs: Limb weakness can be caused by compressed nerves in the spine due to conditions like sciatica or spinal stenosis. However, sudden leg weakness could also indicate a stroke.4. Incontinence: Back pain paired with inability to control the bowels or bladder might be a sign of serious nerve compression or a spine infection, such as discitis or meningitis.5. Numbness or pins and needles in the groin or glutes: This is known as saddle anesthesia and is also a sign of a serious nerve or spine condition.
If you have leg weakness, incontinence, and numbness together, you might have cauda equina syndrome, a serious illness characterized by spinal cord nerve damage. This is a medical emergency, and patients usually need surgery immediately to decompress the nerves and reduce permanent damage.
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What Are The Treatments For Lower Back Pain
Lower back pain usually gets better with rest, ice and over-the-counter pain relievers. After a few days of rest, you can start to get back to your normal activities. Staying active increases blood flow to the area and helps you heal.
Other treatments for lower back pain depend on the cause. They include:
- Medications: Your provider may recommend nonsteroidal anti-inflammatory drugs or prescription drugs to relieve pain. Other medications relax muscles and prevent back spasms.
- Physical therapy : PT can strengthen muscles so they can support your spine. PT also improves flexibility and helps you avoid another injury.
- Hands-on manipulation: Several hands-on treatments can relax tight muscles, reduce pain and improve posture and alignment. Depending on the cause of pain, you may need osteopathic manipulation or chiropractic adjustments. Massage therapy can also help with back pain relief and restore function.
- Injections: Your provider uses a needle to inject medication into the area thats causing pain. Steroid injections relieve pain and reduce inflammation.
- Surgery: Some injuries and conditions need surgical repair. There are several types of surgery for low back pain, including many minimally invasive techniques.
Stay Clear Of Toe Touches
Workout benefits back pain yet not all exercises are advantageous. Any kind of mild pain really felt at the beginning of these exercises ought to vanish as muscle mass end up being stronger.
If tenderness is more than moderate as well as lasts more than 15 mins during exercise, people should stop working out and contact a physician. Some exercises might intensify ache.
Standing toe touches, for instance, placed significantly greater anxiety on the disks as well as ligaments in your back. They can additionally overstretch lower back muscular tissues as well as hamstrings.
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Can Lower Back Pain Be A Sign Of Something Serious Like Cancer
Lower back pain can be related to cancer. In fact, it is one of the first symptoms of prostate cancer when it metastasizes and creates lesions. Almost any cancer can spread to the back and some, like sarcoma, can originate in the back. Be cautious, especially if you are experiencing other symptoms besides lower back pain. Talk to your doctor if you have additional symptoms or concerns.
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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