Urgent Advice: Ask For An Urgent Gp Appointment Or Get Help From 111 If:
You have back pain and:
- a high temperature
- you’ve lost weight without trying to
- there’s a lump or swelling in your back or your back has changed shape
- the pain does not improve after resting or is worse at night
- the pain is made worse when sneezing, coughing or pooing
- the pain is coming from the top of your back , rather than your lower back
How Is A Pinched Nerve In The Back Diagnosed
Your doctor will first ask you about your symptoms. Its important to provide as many details as you can, such as how long youve been experiencing pain and discomfort, how its affecting your quality of life, and whether youve recently experienced any recent injuries.
Next, your doctor will look for physical signs of trauma or other issues in your low back by checking for possible:
- limited range of motion
- changes to reflexes in your legs
- weakness in the muscles
- changes in sensation in the lower extremities
Your doctor may not be able to diagnose the pinched nerve from a physical examination alone. Additionally, they may want to know more about the cause of the pinched nerve.
They may order the following tests to get more information:
- X-ray:shows the bones in your vertebrae
- MRI:shows your soft tissues, including the discs in your vertebrae, your spinal cord, and the nerves in your lower back
- CT scan:shows a very detailed picture of your lower back and can be used to evaluate bony structures and muscles
Such imaging tests are typically ordered in the case of long-term symptoms only. For example, doctors may not order imaging tests for sciatica unless symptoms last for
- physical therapy
- other lifestyle adjustments
Sometimes your doctor will need to treat the pinched nerve with more invasive measures, such as spinal injections or surgery.
Tips For Dealing With Lower Back Pain
By Robert Greenleaf, MD, Spine Surgeon
Lower back pain is extremely common and one of the top reasons for missed workdays. Thats because the lower back supports the weight of the upper body and is subject to a lot of stress and strainespecially during everyday movements like lifting and twisting.
One of two things typically causes lower back pain: a sudden injury or the wear and tear of aging, arthritis and physical activity. No matter the cause of your lower back pain, here are 10 recommendations that can help you relieve it and prevent future problems.
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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.
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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 .
How Is Low Back Pain Treated
Treatment may include:
- A prevention program
- Assistive devices
Rehabilitation is often a part of treatment for low back pain. Generally, there are 3 phases of low back pain rehab.
- Acute phase. During this initial phase, the physiatrist and treatment team develop a plan to reduce the initial low back pain and source of inflammation. This may include using ultrasound, electrical stimulation, or specialized injections.
- Recovery phase. Once the initial pain and inflammation are better managed, the rehab team focuses on helping you return to normal daily activities while starting a specialized exercise program to regain flexibility and strength.
- Maintenance phase. In this phase, you will learn ways to prevent further injury and strain to the back. You will also learn how to start a fitness program to help further increase strength and endurance.
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Pain In Left Lower Abdomen Pregnancy
Left lower abdomen pain during pregnancy can be a sign of several different things, some of which are more serious than others. Its important to know the different causes of pain in this area so you can get the proper treatment.
The most common cause of left lower abdominal pain during pregnancy is constipation. This can be caused by the extra hormones in your body, which slow down your digestive system. You can help relieve this type of pain by drinking plenty of fluids, eating high-fiber foods, and exercising regularly.
Another common cause of pain in this area is round ligament pain. This is caused by the extra weight of the baby and uterus, which puts pressure on the ligaments that support them. This type of pain is usually mild and goes away on its own. You can relieve it by resting, using a heating pad, and taking over-the-counter pain medication if necessary.
Another potential cause of pain in the left lower abdomen during pregnancy is a UTI. This is a common infection that can be caused by bacteria getting into the urinary tract. It can cause pain, burning, and a sensation of needing to urinate frequently. If you think you may have a UTI, see your doctor for treatment.
Finally, there are also some more serious causes of left lower abdomen pain during pregnancy, such as placental abruption or preterm labor. If you experience any of these symptoms, seek medical attention immediately.
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.
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How Is Back Pain Treated
Acute back pain usually gets better on its own. Acute back pain is usually treated with:
- Medications designed to relieve pain and/or inflammation
- analgesics such as acetaminophen and aspirin
- non-steroidal anti-inflammatory drugs such as ibuprofen and naproxen may be sold over the counter some NSAIDS are prescribed by a physician
- muscle relaxants are prescription drugs that are used on a short-term basis to relax tight muscles
- topical pain relief such as creams, gels, patches, or sprays applied to the skin stimulate the nerves in the skin to provide feelings of warmth or cold in order to dull the sensation of pain. Common topical medications include capsaicin and lidocaine.
Exercising, bed rest, and surgery are typically not recommended for acute back pain.Chronic back pain is most often treated with a stepped care approach, moving from simple low-cost treatments to more aggressive approaches. Specific treatments may depend on the identified cause of the back pain.
Sharp Lower Left Back Pain From A Herniated Disc
A herniated disc develops when a disc protrusion ruptures or herniates through the fragile intervertebral disc wall. As a result, the viscous material from the interior of the disc can spill into the spinal canal, generating mid to severe pain from impingement on sensitive nerves. Disc herniation usually originates from gradual, age-related wear and tear referred to as disc degeneration. Common symptoms of herniated discs depend on the location in the spine and if the disc is pressing on a nerve. The most common symptoms a patient will experience include pain in the buttocks, thigh, and calf, numbness or tingling from the affected nerves, and muscle weakness affecting stability and the ability to lift or hold items.
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When Are Diagnostic Tests For Lower Back Pain Necessary
Many patients do not need X-rays in the first few weeks of pain because their pain will end up resolving. Many more do not need CT scans or MRI imaging, which are overly sensitive and often reveal abnormalities not related to the patients pain. These forms of imaging can be extremely useful, however, if a person has chronic or severe pain, and/or neurological symptoms. Blood tests may be ordered if an infection or tumor is suspected.
You Have Unexplained Weight Loss
If you experience sudden weight loss that can’t be explained by diet and lifestyle changes, then you should always pay attention to what your body is telling you. This is especially true when the unexplained weight loss is accompanied by back pain. See your doctor to rule out the possibility of a more severe condition, such as an infection or tumor.
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When Is It An Emergency
Lower left back pain can range from mildly uncomfortable to so severe pain that it ishard to function or move.
If you develop sudden, severe pain in your lower back, seek emergency medical care.
If the pain is milder, but does not resolve within 5-7 days, seek medical care.
If your symptoms worsen, are severe,or you also have fever andchills, go to the nearest medical facility and contact your healthcare provider.
What Are The Risk Factors For Developing Low Back Pain
Anyone can have back pain. Factors that can increase the risk for low back pain include:
Age: The first attack of low back pain typically occurs between the ages of 30 and 50, and back pain becomes more common with advancing age. Loss of bone strength from osteoporosis can lead to fractures, and at the same time, muscle elasticity and tone decrease. The intervertebral discs begin to lose fluid and flexibility with age, which decreases their ability to cushion the vertebrae. The risk of spinal stenosis also increases with age.
Fitness level: Back pain is more common among people who are not physically fit. Weak back and abdominal muscles may not properly support the spine. Weekend warriorspeople who go out and exercise a lot after being inactive all weekare more likely to suffer painful back injuries than people who make moderate physical activity a daily habit. Studies show that low-impact aerobic exercise can help maintain the integrity of intervertebral discs.
Weight gain: Being overweight, obese, or quickly gaining significant amounts of weight can put stress on the back and lead to low back pain.
Genetics: Some causes of back pain, such as ankylosing spondylitis , have a genetic component.
Smoking: It can restrict blood flow and oxygen to the discs, causing them to degenerate faster.
Backpack overload in children: A backpack overloaded with schoolbooks and supplies can strain the back and cause muscle fatigue.
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What Are The Symptoms Of Low Back Pain
Low back pain is classified as acute and chronic. Acute low back pain lasts from a few days to a few weeks. Most acute low back pain will resolve on its own. Chronic low back pain lasts for more than 3 months and often gets worse. The cause of chronic low back pain can be hard to find. These are the most common symptoms of low back pain. Symptoms may include discomfort or pain in the lower back that is:
- Protruding or herniated disk
Left Side Low Back Pain
Many people experience muscle pain on only one side of their back. This can be due to compensating for a sore joint, like a hip or knee. For example, if one of your hip joints is weak, you may be putting strain on the opposite side of your lower back to make up for that.
However, lower back pain on your left side may also be due to:
If you do pull a lower back muscle, there are several things you can help relieve the swelling and pain.
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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.
Common Causes Of Chronic Back Pain
Chronic back painis usually age-related, but can also result from a prior injury. The mostcommon causes include:
- Arthritis of the spinethe gradual thinning of the cartilage inside the spine
- Spinal stenosisnarrowing of the spinal canal that may lead to nerve pain
- Disc problems, such as a herniated or bulging disc
- Myofascial pain syndromeunexplained muscle pain and tenderness
In some cases, its difficult to pinpoint the cause of chronic back pain.If your doctor has exhausted all diagnostic options, its time to seek asecond opinion from a back pain specialist, recommends Nava. Itsimportant not to make rushed decisions or undergo extensive medicalprocedures until the origin of the pain is found. Not only may they nothelp they could make the pain worse, warns Nava.
If the source of the pain is not known or cant be treated, your bestoption may be to work with your doctor on reducing the flare-ups and makingthe pain manageable with nonsurgical treatments.
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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Stretches And Exercises For A Pinched Nerve In The Back
Always discuss any stretches and exercises you may be considering with your doctor before you try them. You want to make sure you dont worsen your symptoms or do anything that causes more pain.
Use a yoga mat, towel, or carpet to lie on when engaging in these stretches. You should do two to three repetitions of these stretches each time, and make sure to take deep breaths while stretching.
Lower Back Pain And Cancer
Cancer involving the lumbar spine is not a common cause of back pain. However, in people who have a prior history of cancer, for example, in the breast or prostate, or who have weight loss or loss of appetite along with back pain cancer needs to be considered.
Night pain can be a clue to cancer in the spine. A benign tumor called osteoid osteoma, which most often affects young people, causes pain that tends to respond well to aspirin. Multiple myeloma is a malignancy that occurs when the plasma cells in the bone marrow begin spreading uncontrollably. It is most common in older people, and can cause pain in many parts of the spine. When tumor or infection are suspected, blood tests may be ordered, including a CBC , sedimentation rate , and protein electrophoresis .
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The Changing Face Of Spinal Surgery
Only a small percentage of patients with back pain are candidates for surgery, but for these patients, advances in techniques have made recovery a much easier road, says Boden of The Emory Orthopaedics and Spine Center.
Fifty years ago, a spine fusion meant a two-week hospital stay, a body cast or brace for months, and a minimum of six months away from normal activities. A spinal fusion is performed by fusing the vertebrae together with bone grafts to eliminate motion between two adjacent vertebrae where motion is causing lower back pain.
Today, minimally invasively techniques allow for smaller incisions, less blood loss, and faster recovery time, Boden says. Some spine fusion techniques can be done on an outpatient basis.
Fifty years from now, Boden predicts that disc replacement will be an alternative to spinal fusion. Moreover, gene therapy will be able to prevent or reverse disc degeneration, and genetic research will help discover genetic sources of back pain, he says.
“Gene therapy for disc regeneration may be more than five years off, but less than 20,” he predicts.
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