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.22shudder 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!
Signs Of Something Serious
So, can back or neck pain be a sign of something serious? An expert helps us navigate the waters.
While back pain is very common and usually benign and self-limiting, there are some signs and symptoms which could indicate a more serious medical condition requiring further evaluation and treatment, says , Medical Director of the University of Missouri Health Cares Comprehensive Spine Center.
According to Dr. Drymalski these red flags can include:
- Persistent fevers
- Progressive worsening of pain despite relative rest
- Recent trauma
Some symptoms can come on suddenly while others can ramp up gradually. There are several conditions that can bring on these so-called red flags.
Acute Back Pain: Short
If your back pain is acute, it probably means your pain came along suddenly. Things like stress, strenuous exercise, an awkward movement or lifting something wrong can all contribute to acute back pain.
Most back pain is diagnosed as acute. With acute back pain, the pain lasts no longer than six weeks. And in most cases, the underlying cause of the pain doesnt pose a serious or long-term problem.
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What Are The Symptoms Of Lower Back Pain
Symptoms of lower back pain can come on suddenly or appear gradually. Sometimes, pain occurs after a specific event, such as bending to pick something up. Other times, you may not know what caused the pain.
Pain may be sharp or dull and achy, and it may radiate to your bottom or down the back of your legs . If you strain your back during an activity, you may hear a pop when it happened. Pain is often worse in certain positions and gets better when you lie down.
Other symptoms of lower back pain include:
- Stiffness: It may be tough to move or straighten your back. Getting up from a seated position may take a while, and you might feel like you need to walk or stretch to loosen up. You may notice decreased range of motion.
- Posture problems: Many people with back pain find it hard to stand up straight. You may stand crooked or bent, with your torso off to the side rather than aligned with your spine. Your lower back may look flat instead of curved.
- Muscle spasms: After a strain, muscles in the lower back can spasm or contract uncontrollably. Muscle spasms can cause extreme pain and make it difficult or impossible to stand, walk or move.
The Perils Of Prolonged Computer Use
Like bone, muscle, and neck pain, currently, lower back pain is commonly seen among children and adults during these unprecedented times. Children have to attend online schooling, classes, and even adults work from home, which is a new normal now. Increased screen time, poor posture, physical inactivity, and erratic schedules have induced back pain in children and adults.
Dr. Mayank Pathak, Orthopedic and Joint-Replacement Surgeon Apollo Clinic, Pune, says, “Initially, the work from the home policy got a green signal from many employees. But, the extended shifts and online classes, lifting heavy objects, poor posture while sitting due to unavailability of specially designed chairs for back and adjustable monitors, many children and adults are complaining of lower back pain as they are sitting for long in the wrong posture. This leads to pain in the spine. Binge-watching movies with a lack of sleep and rest while at home can also cause stiffness and back pain. And those with existing back problems are also having difficulties as their pain has increased.”
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When Is It Time To Visit The Doctor
According to statistics, only a small fraction of individuals will seek medical attention immediately after they experience symptoms of illness. This is especially true when they believe that their symptoms arent indicative of anything serious. Most people consider lower back pain and fever low urgency symptoms, so not everyone will visit a doctor to get a diagnosis.
In many cases, while it may be okay to manage these two problems from the comfort of home, here are some scenarios when you should consider visiting your doctor:
- Persistent, increasing lower back pain that doesnt resolve with over-the-counter pain medications
- Numbness and or tingling, especially in the lower extremities.
- Radiating pain into the legs that
- Leg weakness
- Recurrent fevers that subside and return several times in a day
- Loss of bowel and bladder control
- Inability to feel yourself wipe after toileting
There are a numerous conditions that are characterized by fevers and back pain. Some are more common than others.
Ix Referred Pain To The Lumbar Spine
Pain in the area of the lumbar spine may be due to important problems that are actually unrelated to the back.Referred pain occurs when a problem in one place in the body causes pain in another place. The pain travels down a nerve. For example, a pinched nerve in the neck may cause pain that is felt in the arm or hand. Sources of referred pain may include abdominal aneurysm , tubal pregnancy, kidney stones, pancreatitis, and colon cancer. Clues to these maladies include pain that waxes and wanes over a short period, with frequent peaks of intense pain, weight loss, abnormalities found during abdominal exam, and trace amounts of blood in the urine.
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Looking To The Longer Term
If your symptoms don’t settle, or suggest an underlying problem, you may be referred for further tests. These include CT or MRI scans, which can look at your discs and nerves as well as the bones of the spine. In severe cases, surgery is sometimes recommended, although there are risks because the surgeon is operating very close to your spinal cord. Epidural injections are also an option.
What If I Dont Want Surgery For My Back Pain
Fortunately, most people with back pain dont need surgery. We usually take a conservative approach first, using a wide variety of nonsurgical spine treatments, said Dr. Guo. For example, I might send you to physical therapy or chiropractic therapy. I might recommend medications such as anti-inflammatories, muscle relaxants, or some nerve-pain medications. We offer injection therapy, including epidural injections, joint injections, and nerve blocks and ablation if your back pain fails to improve with the conservative treatments. Chances are, one of these approaches will help reduce your back pain and improve your function and quality of life.
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The Dangers Behind Lower Back Pain And Fever
Lower back pain is the most common reason stated for work-related absences. This type of pain will often have pronounced impact on overall performance and motivation. But because an achy back caused by occupational factors can often be resolved with a little rest, we tend to brush it off as a trivial problem.
But did you know that some cases of backache might require much more than a rest day? Those that come hand in hand with other symptoms of illness can be indicative of something far worse than just a typical case of a bad back. For instance, a fever coupled with back pain can spell a worlds worth of different conditions. Some of these might be easily remedied with medication and rest. Others could lead to potentially life-threatening complications in the long run.
If youve been having bouts of lower back pain that comes hand in hand with heightened body temperature, it might be time to act. Read on through to find out just what these symptoms might mean.
Of course, as always note that the information in this article is purely informative and should never be used in place of the advice of your treating physicians.
Where Can I Get More Information
For more information on neurological disorders or research programs funded by the National Institute of Neurological Disorders and Stroke, contact the Institute’s Brain Resources and Information Network at:
Office of Communications and Public LiaisonNational Institute of Neurological Disorders and StrokeNational Institutes of HealthBethesda, MD 20892
NINDS health-related material is provided for information purposes only and does not necessarily represent endorsement by or an official position of the National Institute of Neurological Disorders and Stroke or any other Federal agency. Advice on the treatment or care of an individual patient should be obtained through consultation with a physician who has examined that patient or is familiar with that patient’s medical history.
All NINDS-prepared information is in the public domain and may be freely copied. Credit to the NINDS or the NIH is appreciated.
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Common Causes Of Back Pain
Back pain is a generalized condition with many possible causes. Acute pain is usually caused by a specific trigger, often injury or strain. Chronic pain, which lasts longer than 3-6 months, is much less common.
According to the Mayo Clinic, causes of back pain include :
- Muscle or ligament strain: Repeated heavy lifting or a sudden awkward movement may strain back muscles and spinal ligaments. If your muscles are weak, straining them regularly can cause painful muscle spasms.
- Bulging or ruptured disks: Spinal disks act as cushions between the bones in your spine. The inside of these disks is soft and can bulge or rupture during injury. This, in turn, may apply pressure to a spinal nerve. Oddly enough, its possible for this to occur without you experiencing back pain. An x-ray is all you need to diagnose the condition.
- Arthritis: Osteoarthritis can affect any bone in your body, even the spine and pelvic bone. This causes pain in the lower back.
- Skeletal irregularities: Scoliosis, a condition causing spinal curvature, is a possible cause of chronic back pain. Scoliosis is treated by wearing a specialized back brace and may require corrective surgery.
Chronic back pain can also be the symptom of a dangerous or even fatal disease.
Back Sprain Or Strain
Symptoms typically include:
- Muscle spasms, cramping, and stiffness.
- Pain in the back and sometimes in the buttock. It may come on quickly or gradually. It most often occurs in episodes. Certain movements make it worse, and doing light activities such as walking makes it feel better. The worst pain usually lasts 48 to 72 hours and may be followed by days or weeks of less severe pain.
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When To Contact A Medical Professional
- Back pain after a severe blow or fall
- Burning with urination or blood in your urine
- History of cancer
- Loss of control over urine or stool
- Pain traveling down your legs below the knee
- Pain that is worse when you lie down or pain that wakes you up at night
- Redness or swelling on the back or spine
- Severe pain that does not allow you to get comfortable
- Unexplained fever with back pain
- Weakness or numbness in your buttocks, thigh, leg, or pelvis
Also call if:
- You have been losing weight unintentionally
- You use steroids or intravenous drugs
- You have had back pain before, but this episode is different and feels worse
- This episode of back pain has lasted longer than 4 weeks
More Advanced Care Options
Surgery When other therapies fail, surgery may be considered to relieve pain caused by worsening nerve damage, serious musculoskeletal injuries, or nerve compression. Specific surgeries are selected for specific conditions/indications. However, surgery is not always successful. It may be months following surgery before the person is fully healed and there may be permanent loss of flexibility. Surgical options include:
Implanted nerve stimulators
- Spinal cord stimulation uses low-voltage electrical impulses from a small implanted device that is connected to a wire that runs along the spinal cord. The impulses are designed to block pain signals that are normally sent to the brain.
- Dorsal root ganglion stimulation also involves electrical signals sent along a wire connected to a small device that is implanted into the lower back. It specifically targets the nerve fibers that transmit pain signals. The impulses are designed to replace pain signals with a less painful numbing or tingling sensation.
- Peripheral nerve stimulation also uses a small implanted device and an electrode to generate and send electrical pulses that create a tingling sensation to provide pain relief.
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Is It Muscle Strain Or Sciatica
Back pain that occurs after excessive exercise or heavy lifting is frequently a strain injury. However, occasionally these activities cause disc injury and rupture or herniation. When a herniated disc irritates the sciatic nerve, it can cause back pain and, in some people, leg pain.
What is Sciatica?
Sciatica is a form of nerve pain caused by pressure on the sciatic nerve. The sciatic nerve is a large nerve that runs down through the buttocks and extends down the back of the leg. Pressing on or pinching of the sciatic nerve causes shock-like or burning low back pain. Sometimes people feel as if the pain radiates down through the buttocks and down one leg, sometimes even reaching the foot.
Lower Back Pain Symptoms Diagnosis And Treatment
The lumbar spine, or low back, is a remarkably well-engineered structure of interconnecting bones, joints, nerves, ligaments, and muscles all working together to provide support, strength, and flexibility. However, this complex structure also leaves the low back susceptible to injury and pain.
Watch:Lumbar Spine Anatomy Video
This article presents a model for understanding symptoms, physical findings, imaging studies, and injection techniques to come to a precise diagnosis.
Once an accurate diagnosis of the cause of the lower back pain is attained, treatment options can be selected based on todays best medical practices.
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Howto Find Relief If The Pain Is Spinal Stenosis
If you do have spinalstenosis, there are several treatments:
Whenyour Back Pain Could Be A More Serious Medical Problem
There are a few ways to tellthe difference between spinal stenosis and something more serious:
- Pain that gets worse when going uphill is more common with peripheral arterial disease, a buildup of plaque in the blood vessels leading to the your limbs.
- Arterial disease patients dont get relief from the grocery cart position.
- If your symptoms are worse at night but better with exercise, neuropathy may be to blame.
- In younger people, morning stiffness that lasts longer than 30 minutes and gets worse with stillness may be a sign of inflammatory arthritis, such as ankylosing spondylitis.
- Other unexplained symptoms such as weight loss and fatigue may be signs of a cancerous growth very rare, but absolutely worth looking into.
Serious issues such asmalignancies or abdominal aortic aneurysms rarely present with spine symptoms,Dr. Khalaf says, but sometimes they do. Theyre serious enough that rulingthem out is important.
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Or You Could Be Dying What Are The Odds That Back Pain Is Something Scary
Of course there are cases of low back pain that have alarming causes, but its reassuringly rare. Once in a while back pain is a warning sign of cancer, autoimmune disease, infection, or a handful of other scary culprits.7 Over the age of 55, about one in twenty cases turns out to be a fracture, and one in a hundred is more ominous.8 The further you are from 55, the better your odds.
But how can you tell? It can be tricky. This is a concise, readable guide to symptoms that need better-safe-than-sorry investigation with your doctor. In other words, this article explains the difference between dangerous and just painful as clearly as possible. Tables, checklists, and examples ahead.