How Is Chronic Back Pain Diagnosed
Your healthcare provider will ask if you have any medical conditions. He or she may ask if you have a history of back pain and how it started. He or she may watch you stand and walk, and check your range of motion. Show him or her where you feel pain and what makes it better or worse. Describe the pain, how bad it is, and how long it lasts. Tell your provider if your pain worsens at night or when you lie on your back.
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.
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.
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Low Back Pain Surgery
Spine surgery is not necessary for most people who have lower back pain. If you do need it, your doctor will recommend an appropriate procedure to address your specific symptoms and medical situation. Common spine surgeries include:
. Two or more vertebrae are permanently fused together to limit excess spinal motion. Your surgeon will use a combination of bone, bonelike material, screws, plates and rods to hold the vertebrae together so they can heal into a single unit. Spinal fusion may be done to correct spinal deformities or to increase the spines stability in severe cases of spinal osteoarthritis or herniated discs.
. Laminectomy is a surgery in which your surgeon removes the back portion of one or more vertebrae to create more space for the spinal cord or other nerves. In people with severe arthritis, bone spurs within the spinal canal can grow large enough to press on the spinal cord, causing pain and limiting mobility. In a similar surgery known as laminotomy, your surgeon will remove a small piece of bone called the lamina from the back of the vertebra.
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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One Back Pain Treatment You Probably Dont Need
Back pain can be incredibly frustrating, and going under the knife may seem like the quickest, easiest fix to bring relief. But the truth is, many people dont need surgery for lower back pain management, Dr. Park says.
If your back pain is musculoskeletal, you will not require surgery, but if its a pinched nerve thats due to a disc herniation or something else, you may need to have surgery, he says. But even in those people, when you go through a six-to-eight-week course of treatment that includes physical therapy and activity modification, 85 to 90 percent of the time, they wont need surgery.
However, if you try the treatments above and dont see any improvement or still feel pain, talk to your doctor about a referral to a pain management specialist, as more specific tests or treatments may be required to get to the bottom of whats going on.
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Concerned About Your Back Pain Symptoms We Can Help
Most back pain goes away on its own. But if your back pain has been lingering for more than two weeks without improvement, its been coming and going for some time, or if youre experiencing any alarming symptoms, dont delay the care you need. After all, its much easier to take care of yourself when you can move without pain.
Think TRIA Neck and Back Strengthening Program may be right for you? Schedule a consultation.
Not ready for an intensive physical therapy program? Start with physical therapy.
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When Should I Call My Doctor
- You have severe pain.
- You have new numbness, tingling, or weakness, especially in your lower back, legs, arms, or genital area.
- You lose control of your bladder or bowel movements.
- You have a fever or sudden weight loss.
- You have new or worse pain.
- You have questions or concerns about your condition or care.
Lower Back Pain Causes: 8 Reasons For Sudden & Chronic Pain
Sometimes, you know exactly why your back is hurting. Maybe you lifted something awkwardly and felt the pain right away. Or maybe your doctor has been warning you for years that your bad posture would lead to lower back pain.
But other times, the source of back pain can feel like a mystery.
“Your lumbar spine, located in your lower back, plays a crucial role in supporting the weight of your upper body. It’s also responsible for everyday movements, such as bending, twisting and coordinating the muscles in your hips, pelvis legs and feet,” says Dr. Kenneth Palmer, orthopedic surgeon specializing in spine surgery at Houston Methodist. “Due to heavy use, the bones, muscles, ligaments, disks and nerves found in your lumbar spine are quite susceptible to both injury and wear and tear over time causing pain in the lower back.”
Lower back pain symptoms include:
- Dull ache in your hips and/or pelvis
- Muscle spasms or tightness
- Sharp, tingling pain that starts in your lower back and travels down one leg
- Pain that worsens with sitting and quickly improves while walking
- Pain that is noticeably worse in the morning
“Typically, a person experiences some combination of these symptoms, which can develop suddenly or over time. In some cases, lower back pain can feel like it comes and goes flaring up now and then, but generally getting progressively worse over time,” explains Dr. Palmer.
Speaking of the various causes of lower back pain…
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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.
Injections And Other Procedures
If you have severe sciatica, your doctor may suggest an epidural injection. Epidural injections contain a local anaesthetic and steroid to relieve pain and reduce inflammation. Theyre only recommended for sciatica and not non-specific lower back pain.
If your back pain is chronic and other treatments havent helped, your doctor may suggest a procedure called radiofrequency denervation. Its only suitable for certain types of back pain. Your doctor will refer you to a specialist to assess whether it would help you.
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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.
Ok So This Is An Issue What Do We Do About It
First, if you think you have any back issues that are major or beyond regular discomfort, consult your doctor. Slipped or herniated discs in your back are nothing to try and remedy yourself, but they can be overcome with a good physical therapist or surgery.
But for those having a lighter discomfort level, sit up a little straighter and keep reading. Here are the most common things that cause low back pain and some suggestions for fixing or alleviating the pain.
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Is It Muscle Strain Or Sciatica
Back pain that occurs after excessive exercise or heavy lifting is frequently a strain injury. However, occasionally these activities cause disc injury and rupture or herniation. When a herniated disc irritates the sciatic nerve, it can cause back pain and, in some people, leg pain.
What is Sciatica?
Sciatica is a form of nerve pain caused by pressure on the sciatic nerve. The sciatic nerve is a large nerve that runs down through the buttocks and extends down the back of the leg. Pressing on or pinching of the sciatic nerve causes shock-like or burning low back pain. Sometimes people feel as if the pain radiates down through the buttocks and down one leg, sometimes even reaching the foot.
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When To See A Specialist For 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.
Next Steps:
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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
Could Lower Back Pain Be Kidney Pain
It absolutely can. Kidneys are located on the back side of your body and kidney pain can sometimes feel like back pain. The only true way to tell the difference is to visit a doctor who can conduct a thorough examination.
Back Pain Causes and Treatments Webinar | Stephanie Van, M.D.
Chronic back pain is a persistent source of discomfort for many adults. In this webinar, our expert Stephanie Van, M.D., discusses common causes of back pain along with strategies for relief.
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How To Fix Lower Back Pain In Women
The treatment of low back pain depends on the underlying cause, which is yet another reason why you should schedule an appointment and see the doctor for symptoms you experience. The doctor evaluates each patient, assesses your health status and physical activity level and recommends different tests to rule out other conditions with similar symptoms in order to make an accurate diagnosis.
In cases when lower back pain is associated with other health conditions, then treatment for that problem can also help alleviate pain and discomfort. Depending on the diagnosis, patients have different treatments to try, but a combination of different approaches seems to be the most effective.
When it comes to lower back pain, youre not helpless. There are many things you can do to alleviate pain and discomfort and improve quality of life. Here are some treatment options even your doctor will recommend:
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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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.
What Cause Lower Back Pain In Females
Posture. Another common cause of lower back pain in women is poor posture. Poor posture puts unnecessary strain on the spine and muscles in the back, which can lead to pain and discomfort. Women are especially susceptible to poor posture due to factors such as wearing high heels or carrying heavy purses.
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What Causes Chronic Pain In The Lower Back
This includes lumbosacral muscle strain, disk herniation, lumbar spondylosis, spondylolisthesis, spondylolysis, vertebral compression fractures, and acute or chronic traumatic injury. 1 Repetitive trauma and overuse are common causes of chronic mechanical low back pain, which is often secondary to workplace injury.
When to seek help for mechanical back pain?
Acute back pain in the absence of progressive neurologic deficits and other underlying nonmechanical causes may be treated conservatively, with specific emphasis on maintaining activity levels and function. Mechanical back pain persisting for more than 4 to 6 weeks may warrant further diagnostic testing and imaging.
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Chronic Lower Back Pain
When back pain continues for more than three months, it is considered chronic. Although for most people an episode of back pain is over by that time, in some cases it progresses and can have a major impact on ones ability to function. For some patients, physical therapy with local heat or ice application , combined with a home exercise program and education in proper positions for lifting and other movement techniques can make a major difference. Patients must learn to tolerate a certain degree of pain, or they may allow themselves to become more disabled than necessary. Patients at the Hospital for Special Surgery have had success with graded exercise to work through the pain, gradually increasing the exercise quota at each session so they can learn to tolerate more exercise in spite of the pain, and get back to work and activities. Read more detail on this topic in .
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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 .
