What Could Cause Your Lower Back To Hurt

How Is Lower Back Pain Diagnosed

Your provider will ask about your symptoms and do a physical exam. To check for broken bones or other damage, your provider may order imaging studies. These studies help your provider see clear pictures of your vertebrae, disks, muscles, ligaments and tendons.

Your provider may order:

• Spine X-ray, which uses radiation to produce images of bones.
• MRI, which uses a magnet and radio waves to create pictures of bones, muscles, tendons and other soft tissues.
• CT scan, which uses X-rays and a computer to create 3D images of bones and soft tissues.

• Electromyography to test nerves and muscles and check for neuropathy , which can cause tingling or numbness in your legs.

  Depending on the cause of pain, your provider may also order blood tests or urine tests. Blood tests can detect genetic markers for some conditions that cause back pain . Urine tests check for kidney stones, which cause pain in the flank .

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.

What Exactly Is The Lower Back Anyway

Your lower back is known as the lumbar region of the spine. It has a lot of heavy lifting to do: The lumbar spine carries the weight of your entire upper body, plus biomechanical stresses that occur with movement.

The lumbar spine has five vertebraebackbones. Each vertebra has a large disc cushiony gel wrapped in a tough membrane on its front side that acts as a shock absorber. Each vertebra also has two cartilage-lined facet joints on its back side. Working together, discs and facet joints allow the spine to safely bend and twist.

Your lower back also includes ligaments, tendons, and muscles. Ligaments are strong bands that hold the vertebrae and discs together. Tendons attach muscles to the vertebrae. These structures help limit excessive movement that could harm the spinal cord.

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What To Do If You Suspect Something Else

Theres only one major tiphere: See a doctor, whether it is your primary care physician or aspecialist. Each condition that mimics spinal problems comes with its own treatments,but the first step is an accurate diagnosis. For example, a nerve test such aselectromyography can help a doctor spot neuropathy, and a blood-flow testsuch as the ankle-brachial index can distinguish between spinal stenosisand peripheral arterial disease.

Its so important to look atall of your symptoms and history and do a thorough examination, Dr. Khalafsays. Its how we can tell the difference between a back issue and a medicalcondition.

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 .

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Other Conditions That Cause Back Pain

Sometimes pain felt in the back actually originates elsewhere in the body. Such problems may include: prostate trouble in men problems with reproductive organs in women kidney diseases, such as an infection or kidney stone diseases of the intestines or pancreas, such as cancer or a blockage cancer that has spread to the spine multiple myeloma, a form of cancer of the bone and bone marrow curvature of the spine rarely, a tumor on the spinal cord

How Can I Tell If My Back Pain Is Serious

You should get medical care right away if:

You are older than 50

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How Is Low Back Pain Treated

Treatment may include:

• A prevention program
• Surgery
• Assistive devices

Rehabilitation is often a part of treatment for low back pain. Generally, there are 3 phases of low back pain rehab.

• Acute phase. During this initial phase, the physiatrist and treatment team develop a plan to reduce the initial low back pain and source of inflammation. This may include using ultrasound, electrical stimulation, or specialized injections.
• Recovery phase. Once the initial pain and inflammation are better managed, the rehab team focuses on helping you return to normal daily activities while starting a specialized exercise program to regain flexibility and strength.
• Maintenance phase. In this phase, you will learn ways to prevent further injury and strain to the back. You will also learn how to start a fitness program to help further increase strength and endurance.

Chronic Low Back Pain Of No Specific Origin

Low back pain is defined as pain, tightness, and stiffness between the lower end of the rib cage and the buttocks. “Chronic” means the pain has lasted for twelve weeks or longer, and “no specific origin” means the pain cannot be traced to any specific cause, incident, or injury.

Most susceptible are individuals who perform heavy physical work, especially when there is ongoing anxiety, depression, and emotional stress at the same time. The longer the stress and back pain continue, the more difficult it is to ease the symptoms and return the patient to normal functioning.

Treatment involves nonsteroidal anti-inflammatory drugs and sometimes opioid medications for pain, though both have risks when used long term. Antidepressants may also be tried, along with psychological counseling.

Corticosteroid injections for the back are effective for some patients, and fusion surgery is sometimes attempted. Lifestyle changes in the form of improved diet, exercise, and stress management are very helpful in most cases.

Rarity: Common

Top Symptoms: lower back pain, unintentional weight loss, back pain that shoots to the butt, fever, involuntary defecation

Symptoms that always occur with chronic low back pain of no specific origin: lower back pain

Symptoms that never occur with chronic low back pain of no specific origin: thigh numbness, buttocks numbness, lower back pain from an injury

Urgency: Primary care doctor

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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.

Who Should I See For Lower Back Pain

Your primary care physician knows you best and should be your first contact for lower back pain. If he or she is unable to diagnose or treat the issue, you may get referred to a specialist, such as a rehabilitation physician . These specialists practice a comprehensive approach to lower back pain, and can diagnose and treat a variety of conditions that have lower back pain as a symptom.

Later, you may get referred to a physical therapist, a chiropractor or another practitioner depending on the nature of your back pain. The good news is that surgery is rarely needed for lower back pain. Only about one in ten patients needs lower back surgery, Chhatre says.

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How Is Lumbar Strain Treated

Treatment will depend on your symptoms, age, and general health. It will also depend on how severe the condition is.

Treatment may include:

• Ice packs or heat and compression applied to the back
• Exercises
• Stretching and strengthening exercises
• Learning how to use and wear appropriate protective equipment

Medicines, such as anti-inflammatories, muscle relaxants, and spinal injections, may also be used to ease pain and inflammation.

You’re Having Problems With Your Bowels Or Urination

If your back pain is paired with a loss of control over your bowels or urination, then it’s time to seek help immediately at a local emergency room. These symptoms point to cauda equina syndrome, where the nerves in the lower spine have become paralyzed. While rare, this syndrome can be permanently damaging to the nerves if left untreated. If you experience these symptoms, especially accompanied by numbness in the legs, then you may need surgery to decompress the nerves and preserve their overall function.

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Common Causes Of Chronic Lower Back Pain

“Chronic lower back pain is less likely to be caused by injury to your muscles and ligaments and more likely to be due to issues with the lumbar disks, nerves, joints or vertebrae,” says Dr. Palmer. “There are several potential causes of chronic pain in the lower back.”

In general, osteoarthritis and degenerative disk disease are the underlying cause of many types of chronic lower back pain. However, lower back pain can also be caused by accident-related trauma and acute stress.

What Does It Mean If Lower Back Pain Is Shooting Into Legs

Lower back pain can radiate to other parts of the body: up or down from its place of origin. Sometimes lower back pain can be on one side of the back, which is also normal.

If the pain is shooting from the lower back into one or both legs, it could be sciatica , but its not always the case. There are many parts in the lower back that may cause the pain to radiate into the legs, such as facet joints, sacroiliac joints, muscles or inflammation of the bursa.

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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.

Less Common Causes Of Low Back Pain

While considerably less common, low back pain may also be caused by:

Infection. Also called osteomyelitis, a spinal infection is rare but can cause severe pain and is life threatening if untreated. It can be caused by surgical procedures, injections, or spread through the blood stream. Patients with a compromised immune system are more susceptible to developing an infection in the spine.

Tumor. Most spinal tumors start in another part of the body and metastasize to the spine. The most common tumors that spread to the spine start from cancer in the breast, prostate, kidney, thyroid, or lung. Any new symptoms of back pain in a patient with a known diagnosis of cancer should be evaluated for possible spinal metastasis.

Autoimmune disease. Back pain is a possible symptom associated with autoimmune conditions, such as ankylosing spondylitis, rheumatoid arthritis, lupus, crohns disease, fibromyalgia, and others.

This list includes the more common causes of back pain, but there are many more. Finding the optimal treatment for low back pain usually depends on obtaining a correct clinical diagnosis that identifies the underlying cause of the patients symptoms.

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Diagnosis Of Back Pain

Regardless of what type of doctor you see, there are some things you can expect your doctor to do during your visit. Your doctor first will ask you a number of questions, the most common of which are listed as follows:

• What are your symptoms–that is, what aches or pains do you have?
• Exactly where is the pain?
• Where is the pain the most severe?
• When did the pain begin?
• How long have you had it?
• Did something specific cause your back pain, such as an accident or injury?
• What home treatments have you used?
• Were you under any additional stress when the pain began?
• Do you have any other health problems?
• What kind of work do you do?
• In what types of recreational activities do you participate?

Think about these ahead of time so you can answer them easily. You also may have questions you’d like to ask the doctor. As you think of questions at home, jot them down and take them to the appointment.

Next, your doctor will give you a physical exam. During the exam, the doctor may perform any of the following: observe your muscles and joints ask you to sit and lie down ask you to move your back in different positions observe and feel the area of most pain and/or check to see if other areas of your body are tender or painful If the doctor can identify the likely cause of your back pain at this point, no further tests will be needed.

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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How Can I Prevent Back Pain In The Future

While Dr. Williams and the caring team at Interventional Orthopedics of Atlanta are hyper-focused on helping patients become pain-free, preventing future pain is one of their top priorities. Follow these lifestyle and behavioral tips to help ensure you avoid back pain in the future:

• Sleep with your spine in a neutral position
• Practice good posture

Fractures And Lower Back Pain

are often very difficult pain problems and indicate the possible presence of . In patients with severe osteoporosis, spinal fractures can occur with no early warning and no significant trauma the patient does not have to fall to fracture a vertebrae.

Patients with spinal compression fractures experience spasms and, often, very high pain levels.

In patients with low back pain where the cause is difficult to determine, especially for elderly patients with osteoporosis, a fracture in the sacrum may be the cause of the pain. A standard X-ray or bone scan may not show a sacral fracture. Imaging techniques such as CT scan or MRI can often reveal these fractures.

It is very important that patients with acute lumbar compression fractures be tested for osteoporosis. A bone density study is needed, unless the patient has no other osteoporosis risk factors and has had a very high impact fracture. Studies have shown that many patients with fractures in the U.S. are discharged from hospitals with no plans for management of their bone density problems, which then are left to worsen.

Although pain can be very intense, it is best for patients with lumbar fracture to resume activity as soon as possible. This is especially true for elderly patients, who can too easily become weakened, and develop other complications, if mobility is reduced for too long. may be needed for pain control, for as brief a period as possible.

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