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
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.
Can Lower Back Pain Be Related To Weather
If you feel like your lower back pain worsens on days when its cold or the weather is changing, you are not imagining things. Back pain can indeed be related to barometric pressure and outdoor temperature. Changes in pressure can sometimes cause pain in arthritic joints, including the spine. Muscles and joints in general react to the environment, which can make them stiffer and more likely to suffer an injury.
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Acupuncture For Low Back Pain Relief
Acupuncture can be moderately effective for chronic low back pain. With acupuncture, fine needles are inserted into various points around the body.
Acupuncture practitioners hypothesize that when these thin needles are inserted into the skin and then stimulated by twisting or tapping, naturally occurring chemicals such as endorphins, serotonin, and acetylcholine are released to relieve pain.
Anecdotal evidence suggests acupuncture can be an effective pain reliever. Further scientific and clinical studies are underway to prove the efficacy of acupuncture therapy.
Back Muscles And Low Back Pain
Soft tissues around the spine also play a key role in lower back pain.
There is a large and complex group of muscles that work together to support the spine, help hold the body upright and allow the trunk of the body to move, twist and bend in many directions.
Injuries to the back muscles are a common cause of back pain. Watch:Lower Back Strain Video
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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.
Xiii Surgery For Lower Back Pain
Because the vast majority of patients recover from their low back pain with little help from a doctor, the rationale behind choosing surgery must be convincing.Eighty percent of patients with sciatica recover eventually without surgery.
Severe progressive nerve problems, bowel or bladder dysfunction and the cauda equina syndrome make up the most clear-cut indications for back surgery. Back surgery will also be considered if the patients signs and symptoms correlate well with studies such as MRI or electromyogram .
In the most serious cases, when the condition does not respond to other therapies, surgery may well be necessary to relieve pain caused by back problems. Some common procedures include:
- Discectomy removal of disc material that has herniated
- Spinal fusion a bone graft that promotes the vertebrae to fuse together
- Spinal laminectomy removal of the lamina to create more space and reduce irritation and inflammation
To get an in-depth look at surgical procedures for lower back pain, visit .
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Other Conditions That Cause Back Pain In Older Adults
We often see a range of less serious but still painful spine conditions in seniors. Most patients with these conditions will not require surgery. Physical therapy, medication, injectable anesthetics, or a combination of treatments usually can control symptoms.
- Degenerative disc disease, which can cause whole spine pain, and lumbar arthritis, which usually causes low-back pain, commonly develop with age and are considered wear-and-tear conditions.
- Sacroiliitis is an inflammation of the joints that connect your spine and pelvis. This condition can cause pain in the low back, glutes, and upper legs.
- Ankylosing spondylitis is an inflammatory arthritis that causes patients spines to become inflexible, resulting in a continual hunched forward position and spine pain.
- We also check for adult degenerative scoliosis and kyphosis, spine-curving conditions that can result in back pain and weakness in the lower extremities.
Hot Or Cold Therapy For Low Back Pain
Hot or cold packs may help ease pain and reduce symptoms. The soothing relief from heat, or the dulling relief from a cold pack, is only temporary and will not treat more serious causes of back pain. However, they may provide greater mobility for people with acute, subacute, or chronic pain, allowing them to get up and get moving.
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Massage Therapy For Low Back Pain
Studies have shown that massage treatments can help relieve chronic low back pain. Massage treatment can restore people to their usual activities of daily living and lessen pain. Massage therapy is limited, and would not be the most effective solution for patients with spinal complications, injuries, or disk problems since massage focuses on the release of muscle tension and not on the structure of the spine itself.
Other Types Of Diagnosis
- A chiropractor will diagnose through touch, or palpation, and a visual examination. Chiropractic is known as a direct approach, with a strong focus on adjusting the spinal joints. A chiropractor may also want to see the results of imaging scans and any blood and urine tests.
- An osteopath also diagnoses through palpation and visual inspection. Osteopathy involves slow and rhythmic stretching, known as mobilization, pressure or indirect techniques, and manipulation of joints and muscles.
- A physical therapist focuses on diagnosing problems in the joints and soft tissues of the body.
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What Research Is Being Done
The mission of the National Institute of Neurological Disorders and Stroke is to seek fundamental knowledge of the brain and nervous system and to use that knowledge to reduce the burden of neurological disease. NINDS is a component of the National Institutes of Health , the leading supporter of biomedical research in the world.
As a primary supporter of research on pain and pain mechanisms, NINDS is a member of the NIH Pain Consortium, which was established to promote collaboration among the many NIH Institutes and Centers with research programs and activities addressing pain. On an even broader scale, NIH participates in the Interagency Pain Research Coordinating Committee, a federal advisory committee that coordinates research across other U.S. Department of Health and Human Services agencies as well as the Departments of Defense and Veterans Affairs.
Who Should You See For Lower Back Pain
In general, you should start with your primary care doctor for lower back pain. Your doctor can prescribe drugs and recommend lifestyle changes to protect your back and help improve your pain. Your primary care doctor can also provide referrals to specialists and other providers if necessary. This includes:
- Orthopedic surgeons, who specialize in treating conditions related to the joints, muscles and bones. An uses both medical treatments and surgery to manage these types of problems.
- Physical therapists, who work with people to restore function, build strength, and improve flexibility with the goal of relieving symptoms and preventing or improving disability
- Chiropractors, who use spinal manipulation to treat uncomplicated lower back
- Neuromusculoskeletal doctors, who also use manipulation techniques to manage lower back pain
- Neurologists and neurosurgeons, who can address nerve-related causes of lower back pain
- Physical medicine and rehabilitation doctors, who specialize in preventing and minimizing disability from conditions such as lower back pain
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Xii Treatment Options For Acute Lower Back Pain
Most low back pain is due to muscle strain and spasm and does not require surgery. To treat the pain, medications such as acetaminophen , nonsteroidal anti-inflammatory agents , gabapentin or pregabalin and opioids can be used. NSAIDs suppress inflammation, pain and fever by inhibiting certain inflammation-causing chemicals in the body. Acetaminophen reduces pain and fever, but does not inhibit inflammation. Gabapentin and pregabalin, medications that have been used for antiseizure activity, also has the ability to block pain. Opioids provide pain relief and may be prescribed to manage severe acute and chronic back pain. However, opioids have many problems, such as habituation, constipation and lightheadedness, and are avoided when possible and used for the shortest possible duration. Epidural injection is an option if the back pain does not respond to these treatments. Each person is different in terms of response to medication.
Other nonsurgical treatments for lower back pain include IntraDiscal Electrothermal Therapy , nucleoplasty, and radiofrequency lesioning.
What Are The Potential Complications Of Lower Back Pain
Lower back pain can lead to various complications depending on the underlying disease, disorder or condition. The good news is that most cases can be alleviated or minimized by , basic self-care measures, and the treatment plan outlined by your doctor. However, your back pain may become chronic and overwhelming, affecting your quality of life. Research into the diagnosis and treatment of back pain is ongoing, so contact your healthcare professional for the most effective treatments.
Over time, lower back pain can lead to complications including:
- Absenteeism from work or school
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Pain Medications To Treat Back Pain
A wide range of medications is used to treat both acute and chronic low back pain. Analgesic medications are specially formulated to relieve pain. They include over-the-counter acetaminophen and aspirin, as well as prescription opioids such as codeine, oxycodone, hydrocodone, and morphine.
Nonsteroidal anti-inflammatory drugs can also be used to relieve pain and inflammation. Over-the-counter NSAIDS include ibuprofen, ketoprofen, and naproxen sodium. Several others, including a type of NSAID called COX-2 inhibitors, are available only by prescription.
There are also many topical creams or sprays that can dull and soothe low back pain. These are applied to the skin and thus stimulate localized nerves to provide feelings of warmth or cold in order to dull the sensation of pain. Topical analgesics can reduce inflammation and increase blood flow.
What Home Remedies For Lower Back Pain Actually Work
Unless youve had a major injury, such as a fall or car accident, you probably dont need to rush to the doctor for back pain. You may want to try these simple self-care strategies first.
Avoid bed rest. When lower back pain strikes, people often think complete rest will relieve back pain. However, a review of many clinical studies found that patients who retreated to bed actually experienced more pain and recovered more slowly than patients who stayed fairly active
Use ice and/or heat. Many people find that using ice or cold packs for periods of up to 20 minutes at a time helps reduce pain and swelling. Always wrap ice or a cold pack in a thin towel before putting it on your body so you dont injure your skin. You may also find that heat, such as a heating pad or warm bath, eases pain. Ice is recommended in the first 48 hours after injury then you can try a combo of ice and heat.
Try over-the-counter remedies. Short-term use of OTC pain relievers, such as the nonsteroidal anti-inflammatory drugs ibuprofen and naproxen, may ease your lower back pain. Also consider OTC creams, gels, patches, or sprays applied to the skin. They stimulate the nerves in the skin to provide feelings of warmth or cold in order to dull the sensation of pain.
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How Can You Prevent Lower Back Pain
While you cant stop aging or change your genetic makeup, lifestyle changes can help manage and prevent lower back pain. Having a healthy lifestyle may make you less likely to suffer an accidental injury, too.
Improve your physical fitness. People who are not physically fit are more likely to develop lower back pain because strong core muscles help support the lower back.
Stay active. People who lead sedentary lives may be more likely to injure themselves when they do exert themselves. As far as back health is concerned, its better to do a smaller amount of physical activity most days of the week than to sit all week and over-exert yourself on the weekends.
Lose weight if necessary. The more you weigh, the more pressure you have on your lumbar vertebrae. Being overweight or obese can put stress on the back and lead to lower back pain.
Lift heavy objects the right way. Be sure to squat while lifting so that your hips and knees do much of the work. Keep the load close to your chest while you lift.
Your legs, not your lower back, should be the main driver when you’re lifting something heavy.Make your workspace as ergonomic as possible. If you sit at a desk, make sure your chair has plenty of low-back support and your hips are at a right angle to the floor.
Dont use tobacco products. In addition to all the other health problems tobacco use causes, it can restrict blood flow and oxygen to the discs, causing them to degenerate faster.
What Are Other Causes Of Lower Back Pain
Other causes of low back pain include kidney problems, pregnancy, ovary problems, and tumors.
Kidney problems
Kidney infections, stones, and traumatic bleeding of the kidney are frequently associated with low back pain. Diagnosis can involve urine analysis, sound-wave tests , or other imaging studies of the abdomen.
Pregnancy
Pregnancy commonly leads to low back pain by mechanically stressing the lumbar spine and by the positioning of the baby inside of the abdomen. Additionally, the effects of the female hormone estrogen and the ligament-loosening hormone relaxin may contribute to loosening of the ligaments and structures of the back. Pelvic-tilt exercises and stretches are often recommended for relieving this pain. Women are also recommended to maintain physical conditioning during pregnancy according to their doctors’ advice. Natural labor can also cause low back pain.
Ovary problems
Ovarian cysts, uterine fibroids, and endometriosis may also cause low back pain. Precise diagnosis can require gynecologic examination and testing.
Tumors
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Menstruation Or Uterine Dysfunction
Dysmenorrhea, a uterine dysfunction which is the origin of frequent and severe cramping for women during menstruation, also predisposes women to back pain. The condition is classified as either primary or secondary, and with both types, low back pain is a common symptom.
- Primary dysmenorrhea begins when a woman starts her period and perpetuates throughout her life. Its harsh and atypical uterine contractions can result in recurrent and severe menstrual cramping.
- Secondary dysmenorrhea usually begins later in life, and its caused by another condition such as endometriosis or pelvic inflammatory disease.
Dysfunction Of Sacroiliac Joints
Dysfunction of the sacroiliac joints is also called sacroiliitis. You have two sacroiliac joints, one on each side of your spine where it connects with the top of your pelvis. Sacroiliitis is inflammation of this joint. It can affect one or both sides.
Pain in your lower back and buttocks is the most common symptom. The pain is usually made worse by:
- standing
- unexplained weight loss
- pain after a fall or injury
If you need help finding a primary care doctor, you can browse doctors in your area through the Healthline FindCare tool.
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