What Are Other Symptoms And Signs Sometimes Associated With Low Back Pain
Low back pain can cause a wide variety of symptoms and signs depending on the precise cause of the back pain as reviewed above. Symptoms that can be associated with low back pain include numbness and/or tingling of the lower extremities, incontinence of urine or stool, inability to walk without worsening pain, lower extremity weakness, atrophy of the lower extremity muscles, rash, fever, chills, weight loss, abdominal pains, burning on urination, dizziness, joint pain, and fatigue.
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.
Why Is Memory Foam So Uncomfortable
Memory foam mattresses are sensitive to changes in temperature. Thus, they are capable of responding to the bodys heat and molding to the contour of your body in response. When exposed to heat, they get softer, and when exposed to cold, they become harder. So, if you purchased a mattress during the winter season and are unable to break into it, consider increasing the temperature.
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Injections For Low Back Pain Relief
Epidural steroid injections are a commonly used short-term choice for treating low back pain and sciatica. These injections work by reducing inflammation to relieve pain. Injections are intended for short-term use and should not be utilized for an extended period of time as they may worsen pain in the long run.
For those with chronic pain or sever spinal injury, a nerve block may be utilized to prevent nerve conduction in a certain area. This essentially blocks all feeling from nerves. Nerve blocks are typically only used in extreme cases of severe pain.
The Details: But Wait Lower Back Pain Gets More Complicated
Not only is chronic back pain hard to live with, it can also be difficult for practitioners to diagnose due to the overlap of symptoms with other conditions. Traditional diagnostic methods usually begin with a full physical exam and overview of your medical history.
From there, depending on the severity and duration of the pain, your doctor may request blood work to look for signs of inflammation or infection imaging studies such as X-rays, CT scans, or MRIs to look for structural damage or bone or DEXA scans to check for any bone disorders or bone infections and electrodiagnostics to check nerve function with electromyography or nerve conduction studies.11,12
Your observations can provide some of the most important clues to help your doctor make the right diagnosis. Take notes about your condition and bring them with you to your appointment so that you can precisely describe the pain youre experiencing.
Include details about the pain, such as whether its burning, stabbing or aching the time of day when your pain is at its worst and what youre doing at that time and the exact location or locations of the pain within the lower back region.13
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The Tricky One: Cancer As A Cause Of Low Back Pain And The Necessity Of Testing Just In Case When The Symptoms Justify It
Sorry I have to use the C word I know its kind of a bummer. But C happens.
A few cancers in their early stages can be hard to tell apart from ordinary back pain a bone cancer in the vertebrae, for instance and these create a frustrating diagnostic problem. They are too rare for doctors to inflict cancer testing on every low back pain patient just in case. And yet the possibility cannot be dismissed, either! This is an unsolveable problem.
Most cancers and ominous problems will inevitably start to cause other, distinctive, ominous symptoms, and it wont be long before someone catches on that theres more going on than just back pain. So it truly is an extraordinary circumstance for back pain to be ominous without causing other symptoms that raise the alarm.
For example, in 2017, the New England Journal of Medicine reported on a creepy case of slowly growing neurological deficit caused by a very stealthy cancer, which took a lot of diagnostic effort to solve.25shudder So sneaky cancers happen but they are crazy rare.
This is an unholy combination of factors: the exact same symptoms can have either an extremely rare but serious cause, or an extremely common but harmless cause that can be greatly aggravated by excessive alarm!
My favourite epitaph: I told you I was sick!
How To Treat Lower Back Pain
Lower back pain may respond to many different modalities, but it often takes trial and errorand a lot of patienceto find what works for you.
The Tried-and-TrueThe first line of defense is often over-the-counter nonsteroidal anti-inflammatory drugs and/or acetaminophen. Applying topical cold compresses, such as an ice pack, is recommended immediately after first experiencing a lower back injury or onset of pain. Heat therapy, such a heating pad, hot water bottle, or even an Epsom salt bath, can also be used to relax and soothe the surrounding muscles by helping to increase blood flow to the lower back.15
When to Call Your Doctor or SpecialistIf your pain is recent, or mild to moderate but over-the-counter pain relievers and topical compresses dont provide relief, call your primary care doctor. He or she will be able to evaluate what is causing the pain and, if appropriate, prescribe a muscle relaxant. Historically, opioids were commonly prescribed to treat pain, but due to the increasing numbers of opioid-related overdoses and deaths, many practitioners no longer view them as the best strategy for non-cancer-related pain, Jamison explains. However, doctors now can implement opioid risk assessments and monitor urine samples in order to better prevent the risk of opioid abuse, Jamison says.
Depending on your diagnosis, your doctor may refer you to a specialist, such as an orthopedist, physical therapist, or psychotherapist, as needed.
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The Worst Back Pain Is Rarely The Scariest
People understandably assume that the worst back pain is the scariest. In fact, pain intensity is a poor indicator of back pain ominousness,10 and some of the worst causes are actually the least painful . For instance, someone could experience the symptoms of cauda equinae syndrome, and be in real danger of a serious and permanent injury to their spine, but have surprisingly little pain even none at all in some cases!
Meanwhile, many non-dangerous problems can cause amazingly severe back pain. A muscle cramp is a good analogy just think about how painful a Charley horse is! Regardless of whats actually going on in there, muscle pain is probably the main thing that back pain patients are feeling. The phenomenon of trigger points tiny muscle cramps, basically11 could be the entire problem, or a complication thats more painful and persistent than the original problem. Its hard to overstate how painful trigger points can be, but they are not dangerous to anything but your comfort.
Wrapping It Up: Steroids For Back Pain
Steroid injections can be a part of a dynamic pain management plan for patients suffering from pain caused both by irritation of the spinal nerves and certain types of arthritis. While they wonât solve the underlying cause of your pain, they can provide much-needed relief when more conservative methods havenât been successful.
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When To Seek Medical Care For Back Pain
The Agency for Healthcare Research and Quality has identified 11 red flagsthat doctors look for when evaluating a person with back pain. The focus of these red flags is to detect fractures , infections, or tumors of the spine. Presence of any of the following red flags associated with low back pain should prompt a visit to your doctor as soon as possible for complete evaluation.
- Recent significant trauma such as a fall from a height, motor vehicle accident, or similar incident
- Recent mild trauma in those older than 50 years of age: A fall down a few steps or slipping and landing on the buttocks may be considered mild trauma.
- History of prolonged steroid use: People with asthma, COPD, and rheumatic disorders, for example, may be given this type of medication.
- Anyone with a history of osteoporosis: An elderly woman with a history of a hip fracture, for example, would be considered high risk.
- Any person older than 70 years of age: There is an increased incidence of cancer, infections, and abdominal causes of the pain.
- Prior history of cancer
- Unexplained weight loss
The presence of any of the above would justify a visit to a hospital’s emergency department, particularly if your family doctor is unable to evaluate you within the next 24 hours.
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.
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Diagnosing Cancer And Back Pain
A doctor will consider your symptoms and medical history when diagnosing potential lower back pain causes. Its important to include if you have a history of cancer or a family history of cancer.
Because cancer is a rare cause of lower back pain in those who dont already have cancer, a doctor may recommend other treatments before doing a full cancer work-up.
However, if pain persists after physical therapy or anti-inflammatory medications, a doctor may order imaging studies and blood testing. These tests can help identify if there are potential cancer markers that are causing the lower back pain.
Mechanical Lower Back Pain
Because it represents 97% of cases, mechanical low back pain deserves to be discussed first. To determine the factors that bring out the pain, the doctor will consider the following causes of mechanical low back pain:
- Muscle strain.
- Spondylolisthesis .
- .
- Osteoarthritis .
- Spinal stenosis .
Low back pain that gets worse with sitting may indicate a herniated lumbar disc . This is because certain positions of the body can change the amount of pressure that an out-of-place disc can press on a nerve. This is one reason we suggest to people with low back pain to periodically get up and stretch or walk around rather than continually stay sitting. Acute onset, that is, pain that comes on suddenly, may suggest a herniated disc or a muscle strain, as opposed to a more gradual onset of pain, which fits more with osteoarthritis, spinal stenosis, or spondylolisthesis.
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Why Does My Back Hurt On Memory Foam
What exactly is it? The improper frame, a mattress that hasnt had enough time to adjust to your physical features, or a memory foam mattress that isnt a suitable match for your body weight, body type, or dominant sleeping position are all factors that might cause back pain from a memory foam mattress to occur.
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.
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Lumbar Sprain Or Muscle Strain Could Be To Blame
Your lower spine is supported by a network of soft tissues, including muscles, tendons, and ligaments. If you feel irritation, muscle spasms, or tightness across your lower back, hips, or buttocks when walking, the tissues may be damaged. This can lead to lumbar sprain or muscle strain.6
What are the Symptoms of Lumbar Sprain and Muscle Strain?
When you sprain or strain your lumbar spine, the soft tissues in your back can become aggravated and inflamed. The pain can range from slight to debilitating. Depending on the extent of the injury, you may experience:
- Muscles spasms
- Stiffness or soreness in your lower back
- Restricted range of motion
- Tightness in lower back muscles
- Pain that radiates from your back to your buttocks7
Possible Causes Of Lumbar Sprain And Muscle Strain
You can strain your lower back by pulling or twisting your lower back muscles suddenly or awkwardly. Chronic strain can occur if you overuse muscles in a repetitive fashion.
Remember the old saying, Lift with your legs, not with your back? You can also experience muscle strain by lifting something improperly or by putting too much stress on your back muscles.
Lumbar sprain can occur when one or more ligaments in your back are stretched beyond their normal range.
This can happen after a fall, an unexpected twist, or a forceful blow to your body.
Excessive activity from aerobic exercise or low-impact exercise can cause a sprain. Displaying incorrect form while exercising can also be troublesome.
What Is The Treatment For Chronic Nonspecific Low Back Pain
Initial treatment is similar to sudden-onset attacks. That is, aim to keep as active as possible. Also, painkillers can help. In addition to the painkillers listed above, your doctor may advise a course of an antidepressant medicine in the tricyclic group – for example, amitriptyline. Tricyclic antidepressants have other actions separate to their action on depression. They are used in a variety of painful conditions, including back pain.
Also, a national guideline , referenced below) recommends one or more of the following treatments should be considered. Each of these treatments has some evidence from research trials to suggest that they will help to ease symptoms in some people :
- Structured exercise programme. This means a programme of exercise supervised by a professional such as a physiotherapist. This is likely to be in a group setting. Exercises may include aerobic activity, movement instruction, muscle strengthening, posture control and stretching. It typically consists of up to eight supervised sessions over 8-12 weeks with encouragement to keep on doing the exercises at home between sessions.
- Manual therapy. Typically this includes several sessions of massage, spinal mobilisation and/or spinal manipulation. With spinal mobilisation the therapist moves the joints of the spine around in their normal movement range. In spinal manipulation, the therapist moves joints beyond the usual range of movement.
- A course of acupuncture. It is not clear how this may work.
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How To Relieve Back Pain
The following tips may help reduce your back pain and speed up your recovery:
- stay as active as possible and try to continue your daily activities this is 1 of the most important things you can do, as resting for long periods is likely to make the pain worse
- try exercises and stretches for back pain other activities such as walking, swimming, yoga and pilates may also be helpful
- take anti-inflammatory painkillers, such as ibuprofen remember to check the medicine is safe for you to take and ask a pharmacist if you’re not sure
- use hot or cold compression packs for short-term relief you can buy these from a pharmacy, or a hot water bottle or a bag of frozen vegetables wrapped in a cloth or towel will work just as well
Although it can be difficult, it helps if you stay optimistic and recognise that your pain should get better. People who manage to stay positive despite their pain tend to recover quicker.
Back pain usually gets better on its own within a few weeks or months and you may not need to see a doctor or other healthcare professional.
But it’s a good idea to get help if:
- the pain does not start to improve within a few weeks
- the pain stops you doing your day-to-day activities
- the pain is very severe or gets worse over time
- you’re worried about the pain or struggling to cope
If you see a GP they will ask about your symptoms, examine your back and discuss possible treatments.
They may refer you to a specialist doctor or a physiotherapist for further help.
