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What Do I Do When I Have Lower Back Pain

Herniated Disk In The Lower Back

Why do I have lower back pain?

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.

Rarity: Common

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

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.

Will Bed Rest Help Back Pain

Doctors often recommend continuing your usual activities of daily living as soon as possible. Studies suggest that strict bedrest can often prolong or worsen low back pain. Bed rest can also lead to secondary complications such as depression, decreased muscle tone, and blood clots in the legs. You should try and keep moving while avoiding activities that noticeably aggravate or worsen back pain. By staying active, those who suffer from low back pain can gain greater flexibility and quicker recovery.

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Where Can I Get More Information

For more information on neurological disorders or research programs funded by the National Institute of Neurological Disorders and Stroke, contact the Institute’s Brain Resources and Information Network at:

Office of Communications and Public LiaisonNational Institute of Neurological Disorders and StrokeNational Institutes of HealthBethesda, MD 20892

NINDS health-related material is provided for information purposes only and does not necessarily represent endorsement by or an official position of the National Institute of Neurological Disorders and Stroke or any other Federal agency. Advice on the treatment or care of an individual patient should be obtained through consultation with a physician who has examined that patient or is familiar with that patient’s medical history.

All NINDS-prepared information is in the public domain and may be freely copied. Credit to the NINDS or the NIH is appreciated.

When To See A Specialist For Lower Back Pain

What Can I Do About My Lower Back Pain?

If you’re experiencing lower back pain that’s not responding to rest and self-care, it’s time to consider seeing a spine specialist.

“A spine specialist will likely perform a physical exam as well as one or more imaging scans to diagnose the root cause of your lower back pain. Depending on your diagnosis, he or she will then design a treatment plan aimed at alleviating your pain and preventing it from disrupting the everyday activities you enjoy,” says Dr. Palmer.

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Ways To Treat Chronic Back Pain Without Surgery

Back pain is considered chronic if it lasts three months or longer. It cancome and go, often bringing temporary relief, followed by frustration.Dealing with chronic back pain can be especially trying if you dont knowthe cause.

Back pain rehabilitationspecialistAndrew Nava, M.D., offers insights into common chronic back pain causes and nonsurgicaltreatment optionsand advises not to give up hope.

How Is Low Back Pain Diagnosed

Your doctor will likely begin by requesting a complete medical history and conducting a thorough physical examination to determine where youre feeling the pain. A physical exam can also determine if pain is affecting your range of motion.

Your doctor may also check your reflexes and your responses to certain sensations. This determines if your low back pain is affecting your nerves.

Unless you have concerning or debilitating symptoms or neurologic loss, your doctor will probably monitor your condition for a few weeks before sending you for testing. This is because most low back pain resolves using simple self-care treatments.

Certain symptoms require more testing, including:

  • lack of bowel control
  • fever
  • weight loss

Likewise, if your low back pain continues after home treatment, your doctor may want to order additional tests.

Seek medical attention immediately if you experience any of these symptoms in addition to low back pain.

Imaging tests such as X-rays, CT scans, ultrasounds, and MRIs may be necessary so your doctor can check for:

  • bone problems
  • disc problems
  • problems with the ligaments and tendons in your back

If your doctor suspects a problem with the strength of the bones in your back, they may order a bone scan or bone density test. Electromyography or nerve conduction tests can help identify any problems with your nerves.

The Healthline FindCare tool can provide options in your area if you need help finding a doctor.

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There Are Different Types Of Back Pain

Back pain can be acute or chronic . It can feel like a sudden, sharp pain or a dull, constant ache.

Acute back pain lasts from a few days to a few weeks. Its often caused by an accident, fall, or lifting something thats too heavy. Acute back pain usually gets better on its own, without any treatment. But there may be times when you need to get medical care. Find out when to call a doctor or nurse about back pain.

Chronic back pain lasts for more than 3 months. Its much less common than acute back pain. Most chronic back pain can be treated without surgery.

Whats New In This Article

How to Fix Lower Back Pain off to the Side

Fourteen updates have been logged for this article since publication . All PainScience.com updates are logged to show a long term commitment to quality, accuracy, and currency. moreWhens the last time you read a blog post and found a list of many changes made to that page since publication? Like good footnotes, this sets PainScience.com apart from other health websites and blogs. Although footnotes are more useful, the update logs are important. They are fine print, but more meaningful than most of the comments that most Internet pages waste pixels on. I log any change to articles that might be of interest to a keen reader. Complete update logging of all noteworthy improvements to all articles started in 2016. Prior to that, I only logged major updates for the most popular and controversial articles.See the Whats New? page for updates to all recent site updates.

2020 Minor science update, added a citation to a cancer case study.

2020 Added information about back pain as a symptom of COVID-19.

2018 Cited Premkumar et al on red flag reliability .

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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 .

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:

  • its been bothering you for more than about 6 weeks19
  • its severe and/or not improving, or actually getting worse
  • there is at least one other red flag
  • 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.

    Is back pain a symptom of COVID-19?

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    Can I Prevent Lower Back Pain

    You cant prevent lower back pain that results from disease or structural problems in the spine. But you can avoid injuries that cause back pain.

    To reduce your risk of a back injury, you should:

    • Maintain a healthy weight: Excess weight puts pressure on vertebrae and disks.
    • Strengthen your abdominal muscles: Pilates and other exercise programs strengthen core muscles that support the spine.
    • Lift the right way: To avoid injuries, lift with your legs . Hold heavy items close to your body. Try not to twist your torso while youre lifting.

    Treating Lower Back Pain: How Much Bed Rest Is Too Much

    How Do I Fix Lower Back Pain?

    Back pain is one of the most common reasons why people visit a health care provider. The good news is that the pain often goes away on its own, and people usually recover in a week or two. Many people want to stay in bed when their back hurts. For many years, getting bed rest was the normal advice. But current studies recommend no bed rest at all and stress that staying in bed longer than 48 hours not only wont help but it may, in fact, actually delay your recovery. Heres why:

    Staying in bed wont help you get better faster.If youre in terrible pain, lying down for a day to help ease the distress may seem like a good idea, but moderating your activities and staying active in a limited way is a more effective way to control your symptoms. Research suggests that if you can find comfortable positions and keep moving, you may not need bed rest at all.Research shows that:

    • Lying down longer than a day or two day isnt helpful for relieving back pain.
    • People can recover more quickly without any bed rest.
    • The sooner you start moving, even a little bit, or return to activities such as walking, the faster you are likely to improve.

    Who needs bed rest?Almost no one! The only people who might require time in bed are those with unstable spinal fractures awaiting surgery.

    When should I see a health care provider?You should see your health care provider right away if:

    • Heat or ice
    • Ultrasound
    • Manipulation

    Check with your health care provider before starting an exercise program.

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    Lower Right Back Pain Symptoms

    The back provides both strength and stability to the entire body, leaving it vulnerable to many kinds of injury. It’s possible for even severe back pain to be confined to just one side of the back. When the pain is entirely on the lower right side, it may suggest a specific type of injury or illness, and it’s important to have it examined. Low back pain is also called lumbago or sciatica.

    Change Up Your Sleep Position Or Mattress

    Switching to a more supportive sleep position can reduce lower back pain. Also consider how you can use pillows or invest in a new mattress to support better spinal alignment and relieve lower back pain.

    Research suggests medium firm mattresses are the best mattresses for back pain. In one study of people with low back pain, those who slept on medium firm mattresses reported lower pain scores both during sleep and upon getting up in the morning.

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    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:

  • Back pain that could occur on either side, but just happens to be on the right or the left exclusively. This is very common. Most ordinary back pain dominates one side of the back.
  • Back pain that comes specifically from structures that exist only on one side. This is a small category.
  • 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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    Yoga: Stretching For Back Pain

    Why Do I Have Lower Back Pain?

    If back pain doesn’t go away in three months, there’s evidence that yoga can help. In one recent study, people who took 12 weeks of yoga classes had fewer symptoms of low back pain than people who were given a book about care for back pain. The benefits lasted several months after the classes were finished. The study suggests conventional stretching also works just as well. Make sure your instructor is experienced at teaching people with back pain and will modify postures for you as needed.

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    Are You Making Your Back Pain Worse

    Don’t be guilty of exacerbating your already achy back. Try these tips for preventing added low back pain:

    • Wear comfortable, low-heeled shoes if you are on your feet all day.
    • Don’t slouch when standing or sitting.
    • At home or work, make sure work surfaces are at a comfortable height.
    • Warm-up and stretch before exercise or other strenuous physical activity.
    • Don’t try to lift objects that are too heavy and don’t twist while lifting.
    • Live a healthy lifestyle, stop smoking, and keep off the extra weight.

    What Is The Outlook For People With Lower Back Pain

    The outlook depends on the cause of pain. Most people with back strains and sprains recover and do not have long-term health issues. But many people will have another episode within a year.

    Some people have chronic back pain that doesnt get better after several weeks. Older people with degenerative conditions such as arthritis and osteoporosis may have symptoms that get worse over time. Surgery and other treatments are effective at helping people with a range of injuries and conditions live pain-free.

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    Mechanical Lower Back Pain

    Because it represents 97% of cases, mechanical low back pain deserves to be discussed first. To determine the factors that bring out the pain, the doctor will consider the following causes of mechanical low back pain:

    • Muscle strain.
    • Spondylolisthesis .
    • .
    • Osteoarthritis .
    • Spinal stenosis .

    Low back pain that gets worse with sitting may indicate a herniated lumbar disc . This is because certain positions of the body can change the amount of pressure that an out-of-place disc can press on a nerve. This is one reason we suggest to people with low back pain to periodically get up and stretch or walk around rather than continually stay sitting. Acute onset, that is, pain that comes on suddenly, may suggest a herniated disc or a muscle strain, as opposed to a more gradual onset of pain, which fits more with osteoarthritis, spinal stenosis, or spondylolisthesis.

    Chronic Low Back Pain Of No Specific Origin

    Why do I have lower back pain?

    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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