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.
References
When To Worry About Low Back Pain
And when not to! Whats bark and whats bite? Checklists nd red flags and non-scary possible explanations for alarmingly back pain
The bark of low back pain is usually much worse than its bite. The pain almost always makes it seem worse than it is. Even when its unusually severe and/or constant, it probably isnt dangerous.
MRI and x-ray for low back pain are surprisingly unreliable,1 because things like bulging discs usually arent a big deal,2 most back pain goes away on its own,3 and trigger points are common and can be worrisomely intense but arent dangerous.4 Most patients are much better off when they feel confident about these things. The power of justified, rational confidence is a huge factor in back pain.5 Sadly, many healthcare professionals continue to perpetuate the idea of fragile backs,6 which undermines that valuable confidence.
Mononeuropathies Of The Leg
Mononeuropathies can affect nerves in the legs, arms, or other parts of the body. Mononeuropathy means a single nerve or nerve group has been damaged, for example, by a lesion that has developed along a nerve or group of nerves. Carpal tunnel syndrome is a good example of a mononeuropathy, in this case, affecting the wrist area. With mononeuropathy symptoms may be sudden or may develop slowly . Some of the more common mononeuropathies are
- femoral neuropathy
- sciatic nerve dysfunction
- peroneal neuropathy .
- tibial neuropathy .
Symptoms of the neuropathies above would include burning sensation in leg areas where these nerves are housed as well as lack of coordination of these leg muscles. Other symptoms include muscle wasting, pain, and twitching, cramps, and spasms in these nerves. Treatment focuses on isolating the underlying cause of the nerve disorder and addressing it using medications such as injected glucocorticoids and/or physical
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Understanding The Lower Back
The lower back is also called the lumbosacral area of the back. It is the part of the back between the bottom of the ribs and the top of the legs.
Most of the lower back is made up from muscles that attach to, and surround, the spine. The spine is made up of many bones called vertebrae. The vertebrae are roughly circular and between each vertebra is a disc. The discs between the vertebrae are a combination of a strong fibrous outer layer and a softer, gel-like centre. The discs act as shock absorbers and allow the spine to be flexible.
When To Seek Immediate Treatment For Severe Lower Back Pain
A lot of cases of low back pain do not require immediate care, but anyone ought to see a doctor right away if severe low back pain is a result of injury, or if pain is accompanied by any of the following signs:
- Severe, continuous abdominal pain .
- Fever and chills.
- Inexplicable current weight loss.
- Substantial leg weakness.
- Abrupt bowel and/or bladder incontinence either difficulty passing urine or having a defecation, or loss of control of urination or bowel movement .
In cases where immediate treatment is a required, physicians will investigate possible serious causes of the pain, including any kind of spine infection, growth or fracture.
Normally, more youthful individuals are most likely to experience pain in the back from a lower back muscle pressure or from within the disc space itself such as a lumbar disc herniation or lumbar degenerative disc condition.
This article information a description of common signs and their possible causes in more youthful adults. The next page information common reasons for lower back pain in adults older than age 60.
Symptoms: Severe or aching pain in the lower back that begins after activity, unexpected motion, or raising a heavy things.
These lower back pain signs include any mix of the following:
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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.
What Are The Warning Signs Of A Serious Problem
Very rarely back pain or pain that travels down the leg is a sign of a serious problem.
If you have any of the following symptoms, you should seek urgent medical attention:
- difficulty controlling or passing urine
- loss of control of your bowels
- numbness around your back passage or your genitals
- serious weakness in your legs so you find standing really difficult
- severe and ongoing back pain that gets worse over several weeks.
The above symptoms could potentially be linked to a rare but serious condition that needs urgent medical attention.
You may be sent for tests if:
- youve had an injury to your back, for example a bad fall
- your doctor suspects that there may be an underlying cause for your pain
- the pain has lasted for an unusually long time.
In this case a magnetic resonance imaging scan or computerised tomography scan may be needed.
X-rays are much less commonly used because back pain is often caused by problems with soft tissues, such as ligaments and muscles, which cant be seen on x-rays.
Changes to the spine as a result of spondylosis can show up on x-rays. These common changes that happen to us all can appear on x-rays without people having any pain or problems. Because of this, x-rays arent particularly helpful.
Remember that sometimes even after a thorough investigation it might not be possible to say for certain what is causing back pain.
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How Should I Lay When My Back Hurts
Try sleeping with a pillow between or underneath your legs for extra support. If you sleep on your side, put the pillow between your knees and draw them up slightly toward your chest. If you like to sleep on your back, try the pillow under your knees, or roll up a small towel and place it under the small of your back.
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What Are All Common Causes Behind Back Pain
⢠Muscle strain is the most often caused due to back pain.
⢠Sometimes it is also caused by a condition called âsciatica,â and it is often a result of repeated movements such as lifting heavy objects and lying in positions that place pressure on the back or lower back.
⢠Some people might even strain their back by coughing, sneezing, twisting, or bending.
⢠Injury due to accident where the bones in the spine break up resulting in the fracture. Certain conditions such as spondylolysis or osteoporosis are high chances of getting fractures.
⢠Osteoarthritis is the most common type of arthritis that causes lower back pain.
⢠Herniated disc due to slipped, ruptured, or bulge disc and degenerated disc disease due to wear away spine.
⢠Osteoarthritis is also one of the causes of back pain in the spine region.
⢠Back pain is integrated with Core muscles or abdominal muscles. When the core muscles are weak, it affects ligaments, spinal bones, and discs, which causes a lack of stability, eventually causing back pain or lower back pain.
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Treating Lower Back Pain: How Much Bed Rest Is Too Much
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.
Should I See A Chiropractor For My Back Pain
Spinal manipulation is used by chiropractors and osteopathic physicians to treat low back pain in selected patients. Spinal manipulation applies hand pressure to areas of the low back to relax irritated muscle and lessen the intensity of the pain.
Traction, using pulleys and weights to lengthen and stretch the spine can result in temporary relief. Both techniques will not treat any underlying causes of back pain, but rather offer a temporary relief from lower back pain.
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When To See A Doctor
People can often treat back pain with home remedies and some patience. However, a person should speak to a doctor about chronic or severe back pain.
A doctor may recommend physical therapy, medication, or other treatments. People who have existing health conditions or who take regular medications should speak to a doctor before trying any herbs or supplements.
The U.S. Food and Drug Administration do not monitor supplements for purity or quality, so it is essential to research reputable companies first.
Radiating Lower Back Pain Questionnaire
Use our free symptom checker to find out what’s causing your pain.
Severe pain always gets your attention and keeps it there, making you wonder if there is something worrisome that is wrong.
Back pain and outer hip pain area can be especially troublesome, causing you pain when you move, walk, and even when you sleep. Sciatic nerve pain is especially troubling, causing pain in the butt literally and shooting pain in the leg that begins in the mid buttock and runs down the back of the leg down to the ankle.
We’ve put together a handy guide that will help you pinpoint the exact cause of your pain and know how seriousor mild, your condition is and to know if you need to get help immediately or see a doctor at your convenience.
If you are concerned that the cause of your radiating back/hip/leg pain might be something serious, check the more serious possible causes of your pain below to see what doctors say about when to worry about radiating hip and back pain.
You can also consult our handy back pain quiz, which will help you use your symptoms to diagnose possible causes for your pain.
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What Are The Most Common Lower Back Surgery Procedures
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:
Spinal Fusion. 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 and laminotomy. 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.
Unexplained Acute Low Back Pain
Unexplained low back pain means chronic pain that comes on gradually, over time, with no specific injury, event, or illness causing it.
Common causes:
- Prolonged sitting and lack of fitness can weaken back muscles and cause pain from lack of support.
- Ankylosing spondylitis, a form of arthritis.
- Spinal stenosis, a narrowing of the spinal column that puts pressure on the spinal cord.
- Certain types of cancer, in rare cases.
Those most susceptible are over 30, overweight and/or pregnant, and not physically fit. Smoking interferes with healing after any sort of stress to the back.
If there are additional symptoms, medical care should be sought: fever, unexplained weight loss, leg weakness or numbness, or trouble urinating.
An exact diagnosis is made through blood tests and through imaging such as x-rays, CT scan, or MRI.
Once more serious causes are ruled out, treatment may include medications to ease pain, swelling, and inflammation. Steroid injections are useful in some cases.
Overall, exercise and maintaining a healthy weight can be very helpful with easing chronic low back pain.
Rarity: Common
Top Symptoms: lower back pain, back pain that shoots to the butt, fever, back pain
Symptoms that always occur with unexplained acute low back pain:lower back pain
Symptoms that never occur with unexplained acute low back pain:buttocks numbness, thigh numbness, involuntary defecation, fever
Urgency: Self-treatment
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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 .
Know Your Otc Medications
Nonprescription pain relievers can help with muscle aches and stiffness. The two main types of over-the-counter options are nonsteroidal anti-inflammatory drugs and acetaminophen. NSAIDs include aspirin, ibuprofen, and naproxen.
True to their name, NSAIDs help lower inflammation that can lead to swelling and tenderness. But acetaminophen does not relieve inflammation. You can reach for either type of pain reliever for occasional back pain. NSAIDs may work a bit better, Hemani says, if you have arthritis of the spine or other inflammatory conditions.
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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.
