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.
Two Back Pain Situations You Should Take Seriously Right Away No Delay
These two back pain scenarios might be medical emergencies. They do not necessarily mean something horrible is wrong, but its important to make sure.
Isnt it rather obvious that a potential spinal fracture is an emergency?
Youd think so. But consider this story of a motorcycle accident: many years ago, a friend hit a car that had pulled out from a side street. He flew over the car & landed on his head. Bystanders showed their ignorance of spinal fracture by, yikes, carelessly moving him. In fact, his thoracic spine was significantly fractured yet the hospital actually refused to do an X-ray because he had no obvious symptoms of a spinal fracture. Incredible! The next day, a horrified orthopedic surgeon ordered an X-ray immediately, confirming the fracture & quite possibly saved him from paralysis.
Pain + weakness in both legs as symptoms of cauda equina syndrome or not
That said, obviously you should be checked out if you are experiencing true saddle numbness.17 Even if its not CES, any significant malfunction of your plumbing should be taken seriously.
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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What Are Some Other Causes Of Lower Back Pain
The shape of your spine, and well as spinal diseases, are other culprits in lower back pain. Depending on a range of factors, your doctor may look for:
Abnormal spinal curvature. A normal spine resembles a gently curved letter S when seen from the side. Abnormal curves include:
- Lordosis, in which the spine curves too far inward at the lower back
- Kyphosis, in which the spine is abnormally rounded in the upper back
- Scoliosis, in which the spine curves from side to side, often in a C shape
Normal and abnormal curves of the spineArthritis. There are more than 100 types of arthritis, many of which can cause lower back pain. The most common types include osteoarthritis , rheumatoid arthritis, and ankylosing spondylitis.
Cauda equina syndrome . Compression of the bundle of nerves that forms below the spinal cord in the lumbar spine. It is a rare but serious disorder that requires immediate medical attention and possibly emergency surgery. CES got its name from the fact that the fanned-out bundle of nerves resembles the base of a horses tail.
Discitis or osteomyelitis.Both infections of discs and bone can cause severe pain and require prompt medical attention.
Spinal tumors. When cells divide and multiply unchecked, the result is a tumor. Both benign and malignant tumors can cause lower back pain. They can either originate in the spine or metastasize there, meaning theyve spread from somewhere else in the body.
Back Pain And Pregnancy
Back pain during each trimester of your pregnancy can be common, and several causes are to blame. However, you should be sure to talk with your doctor about what youre experiencing, in case the pain may be part of a bigger problem.
Here are a few reasons why you may be experiencing back pain during pregnancy:
Shifting center of gravity
As your baby grows, the center of your bodys gravity moves outward. Your spine and back arch to make up for the change in balance. This put extra stress on the lower lumbar spine.
Weight gain
Weight gain can be a healthy part of pregnancy, but even the little bit youre likely to gain during those 9 months can put more stress on your back and core muscles.
Hormones
As your body prepares to deliver the baby, it releases hormones that loosen the ligaments that stabilize your pelvis and lumbar spine. These same hormones can cause the bones in your spine to shift, which may lead to discomfort and pain.
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Back Pain Symptoms That May Indicate A Serious Problem
See your doctor if back pain doesnt improve within 2 weeks of developing. There are times when back pain can be a symptom of a serious medical problem.
Symptoms that can indicate a more serious medical problem are:
These tips can help ease back pain when it happens. They can also help you prevent back pain in the first place.
Carry less
Heavy briefcases, laptop bags, suitcases, and purses can add unnecessary stress and strain to your neck and spine.
Try to reduce what you need to carry, and use bags that distribute the weight more evenly, such as a backpack. If you can, use a bag with wheels to keep weight off your back entirely.
Work your core
The muscles in and around your abdomen and back help keep you upright and carry you through your physical activities. Strengthening them can also reduce the chances of pain, strain, or damage to your back.
Plug strength training workouts with a core focus into your regular fitness routine a few times a week.
Improve your posture
- are a smoker
- have been diagnosed with a specific condition like arthritis
Your mental health also has an effect on your risk of back pain. You may be at a higher risk of back pain if you have a stressful job or have depression and anxiety.
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.
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Low Back Pain Symptoms: Does Your Back Hurt
Low back pain symptoms range from sharp and stabbing to a dull ache. The pains can be constant or intermittent and positional. Acute low back pain can appear suddenly after injury. Chronic back pain is defined as pain lasting more than three months. Consult a doctor if you have prolonged back pain longer than 72 hours.
How Does The Back Brace Work
According to the manufacturer, the Mueller Lumbar Back Brace has four steel springs that provide firm support and stability. These springs should conform to the shape of a persons lower back. The manufacturer notes that along with stability and support, the springs limit unwanted movement in the lower back that may be causing lower back pain.
A person can adjust the tightness of the brace by using the velcro straps on either side of the brace.
Built-in plastic components maintain the shape of the brace to stop it from bunching up while in use,
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Walking Strengthens The Muscles That Support Your Spine
Your trunk, core, and lumbar muscles play a vital role in maintaining the stability and movement of your lower back. These muscles can become deconditioned and weak from a sedentary lifestyle, causing malalignment of the spine. Over a period of time, there may be an increase in muscular weakness, fatigue, injury, and pain.1 The overall mass of your spinal muscles may also reduce.1,2
When you walk, the health of your back muscles is improved in the following ways1:
- Increases blood flow. Decreased physical activity can cause the small blood vessels of your spine to become constricted, reducing blood flow to the spinal muscles. Walking helps open up the blood vessels, increasing the supply of oxygen and nutrients to these muscles.
- Flushes out toxins. Muscles produce physiologic toxins when they contract and expand. Over time, these toxins can accumulate within the lower back muscle tissues and cause stiffness. Walking helps flush out these toxins and improve flexibility.
These factors combine to help build strength in the muscles of your lower back, adding to the strength and integrity of your lower back.
The Most Common Causes Of Lower Back Pain Are A Strain Or Sprain
Whether you notice it or not, your lumbar spine gets put to work throughout the entire day.
Amid all of this work and motion, a lower back sprain or strain can result from an acute injury, such as one experienced while falling, lifting something too heavy or playing sports. A sprain or strain can also develop over time due to repetitive movements or poor posture.
“Straining a muscle or spraining a ligament are the most common causes of lower back pain,” says Dr. Palmer. “While they can be serious, these common causes of lower back pain aren’t long-lasting taking anywhere from a few days to heal or, at most, a few months.”
Your doctor can help you determine the particular course of self-care that can help heal your lower back pain.
“The treatment for a pulled back muscle or strained back ligament is fairly simple and can include pain and anti-inflammatory medications, muscle relaxers, ice to help reduce inflammation, heat to promote healing, and avoiding strenuous activity until the pain recedes,” explains Dr. Palmer. “The best course of care will depend on the severity of your injury as well as your overall core and lower body strength.”
If your lower back pain persists despite treatment, it may be time to consider other causes of lower back pain.
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Injections And Other Procedures
Depending on the source of your pain for example, if you have sciatica epidural injections may be helpful. Injections in the spine arent recommended for non-specific lower back pain though. If your back pain is chronic and other treatments havent helped, there is a procedure called radiofrequency denervation that uses a needle to treat the pain. This is only suitable for some people and you may need to have other tests beforehand. Speak to your specialist for advice.
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.
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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.
Last Weeks Yoga Study
Like todays study in the Annals, last weeks study in the Archives was sizable , which is usually a good sign. Too many studies of yogaand of alternative medicine in generalhave too few subjects, so they cant be anything but the trial balloons of health research: creative and thought-provoking but rather easily shot down.
Other good things about the Archives study: it was conducted by investigators in the research branch of Group Health Cooperative, a large nonprofit health care organization in Seattle with an excellent reputation, and was funded by National Center for Complementary and Alternative Medicine, which is part of the National Institutes of Health and was created about 10 years ago for the express purpose of evaluating nontraditional treatments like yoga in well-designed trials.
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Emotional Effects Of Lower Back Pain
Back pain affects everyone differently. In some situations, back pain can be become chronic, which means it lasts a long time. Some emotional factors may increase the risk of back pain becoming chronic, including:
- believing that physical activity isn’t helpful or having lots of bed rest
- emotional problems such as feeling depressed, anxious or stressed
- a lack of social support from family and friends
- not wanting to play an active role in your treatment
Although you may think your pain is a warning sign to stop you doing certain activities, its important that you keep active to overcome it. If you have any questions about keeping active, talk to your physiotherapist or doctor. They can reassure you that keeping mobile and being positive about managing your back pain are the keys to helping you recover. Exercise will also help to prevent back pain in future.
Range Of Lower Back Pain Symptoms
Low back pain can incorporate a wide variety of symptoms. It can be mild and merely annoying or it can be severe and debilitating. Low back pain may start suddenly, or it could start slowlypossibly coming and goingand gradually get worse over time.
Depending on the underlying cause of the pain, symptoms can be experienced in a variety of ways. For example:
- Pain that is dull or achy, contained to the low back
- Stinging, burning pain that moves from the low back to the backs of the thighs, sometimes into the lower legs or feet can include numbness or tingling
- Muscle spasms and tightness in the low back, pelvis, and hips
- Pain that worsens after prolonged sitting or standing
- Difficulty standing up straight, walking, or going from standing to sitting
In addition, symptoms of lower back pain are usually described by type of onset and duration:
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What To Do When Low Back Pain Occurs
If you are currently experiencing low back pain, gentle self-care exercises should be started to restore mobility and decrease pain. Since poor posture is a major cause of low back pain,maintaining proper posture is important. Use a small pillow or towel roll to support the spine while sitting. Remember, if pain prevents you from exercising or if pain persists for more than 2-3 weeks, a visit to a physician, physical therapist, or other healthcare provider is necessary.
Is Your Job Causing Back Pain
A job that involves pulling, lifting, or twisting with the low back can cause injury and low back pain. Even prolonged sitting in an awkward position can cause low back pain. Standing on your feet for hours on end? That can cause lower back pain too. The best way to prevent back pain is to know if you are at risk.
Jobs That Can Cause Lower Back Pain
- Airline crew
- Surgeons
- Office personnel
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