When To See A Doctor
There is not always an obvious cause of lower back pain, and it often gets better on its own. Resting, trying hot or cold therapy, taking OTC pain relievers, and gently stretching may help speed up recovery.
However, a person should see a doctor for lower back pain that is severe, does not seem to be getting better, or occurs alongside other concerning symptoms, such as tingling or numbness down the legs.
People with lower back pain should seek immediate medical attention if they also have any of the following symptoms:
- difficulty walking or moving the legs
- loss of bowel or bladder function
- loss of sensation in the legs
- very severe pain
A doctor can help a person identify potential causes of lower back pain and recommend appropriate treatment.
The Many Many Possible Causes Of Pain
As the medical director of the Comprehensive Spine Center at the Brigham, and chief of the division of spine care and pain management at Spaulding Rehabilitation Hospital, Dr. Isaac educates patients about the mechanisms by which the brain and neural pathways can lock them into a chronic pain state.
After taking a patients history and understanding their worries and concerns, Dr. Isaac searches for the causes of their pain, though its not always easy. Take back pain, for example. There are numerous possible pain generators, including:
- The degeneration of intervertebral discs
- The inner nucleus of a disc can herniate outward and start a chemical cascade of inflammatory mediators that injure spinal nerves
- A facet joint, a small stabilizing joint between vertebrae, can develop osteoarthritis
- Ligaments can become injured and strained
- Muscles can sprain or spasm chronically
- Compression within arthritic vertebrae can result in reduced blood flow to spinal nerves and the spinal cord
Whats The Role Of Chiropractic Care
Some doctors refer back pain sufferers to a physical therapist right away. But many people with back pain see acupuncturists, massage therapists, or a chiropractor on their own. Experts disagree about the role of chiropractic care, and there are not many high-quality studies to consult about this approach. As a result, there are a number of questions regarding the role of chiropractic care: Should it be a routine part of initial care? Should it be reserved for people who dont improve with other treatments? Are some people more likely to improve with chiropractic care than others?
The answers to these questions go beyond any academic debate about how good chiropractic care is. Estimates suggest that low back pain costs up to $200 billion a year in the US , and its a leading cause of disability worldwide. With the backdrop of the opioid crisis, we badly need an effective, safe, and non-opioid alternative to treat low back pain.
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Addressing Chronic Pain At Multiple Levels
The habit of fixating on pain can be reversed, says Dr. Isaac, but it can take weeks or months and requires a multi-pronged approach.
The following interventions address the complex issue of chronic pain at many levels. Each component is designed to stimulate the brains ability to change, known as neuroplasticity.
- Knowledge: Remember, pain doesnt necessarily mean damage, and structural abnormalities dont predict pain intensity. Acknowledge that some deeply-held thoughts, fears or misconceptions about pain may be undermining your recovery.
- Anatomical: Mechanical deficiencies are corrected with strengthening exercises during physical therapy or in-home exercise programs, and attention to posture.
- Biochemical: Inflammation can be corrected with oral medications and/or corticosteroids injections.
- Neurological: Knowledge , exercise, meditation, and healthy sleep
- Surgery: Some patients with severe spinal stenosis or herniated discs may have symptoms that can be surgically corrected.
The last component of recovery is emotional. How you deal with pain matters significantly, says Dr. Isaac. Some people have pain, but it doesnt bother them, whereas some people with the same pain can become overwhelmed by fear, worry, and anxiety, even depression. The emotional component is addressed with coping strategies, such as psychotherapy, cognitive behavioral therapy, meditation, and medications, in some cases.
Over The Counter Painkillers
Over-the-counter medication can help alleviate the pain before seeking medical help from a professional doctor. Non-steroidal anti-inflammatory drugs like ibuprofen and naproxen are recommended for use to ease lower back pain. These medications are however not advisable to be taken over a long period of time because of their side effects.Other good options to consider are topical creams with ingredients like salicylate, camphor and eucalyptus oil among other may help soothe the pain.
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Manage The Stress In Your Life
Pain triggers the release of stress hormones that make muscles tighten up. Muscle tension reduces blood flow to tissues, bringing them less oxygen and fewer nutrients. When this happens, you feel pain, explains Dr. Welches.
You cant avoid stress, but you can learn to manage it. Cognitive behavioral therapy and meditation are excellent tools, he says. Skilled therapists can change the way you perceive stress. Meditation can reduce anxiety, provide a calm sense of focus and reduce pain.
Its Difficult To Know Whats Causing Your Pain
Sometimes pain in the back or the neck is acute. It often results from an injury maybe you moved heavy furniture without warming up your muscles, you made a sudden movement working in the yard, or youre ill. Acute pain typically goes away on its own without treatment after a few days or weeks.
However, chronic pain lingers and persists for more than 12 weeks. It can be constant or it can come and go, but it typically requires some type of treatment.
Several things can cause back pain and neck pain:
- sedentary living
- kidney stones
- illnesses
Its important to see a medical professional because there are so many possible causes for your pain. A neurologist can help diagnose the source of your back pain, and recommend the best treatment approach, which may involve physical therapy, seeing a pain specialist, or consulting with a surgeon.
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Are There Risk Factors For Developing Back Pain
Back pain can affect anyone. However, there are several risk factors, such as:
- Age. Lower back pain usually affects older people. Several painful conditions can develop with age, such as osteoporosis, spinal stenosis, and osteoarthritis.
- Being overweight. Being obese puts significant stress on the back.
- Fitness level. Weak abdominal muscles provide insufficient support for the spine.
- Genetics. Some hereditary conditions can lead to lower back pain, such as ankylosing spondylitis in which the joints of the spine fuse.
- Work-related risks, like lifting heavy things. Sitting at a desk all day and poor postures can also cause back pain.
- Mental health issues. Depression, anxiety, and stress can alter one’s perception of pain. Chronic pain can also contribute to mental health problems that can lead to physical problems.
- Pregnancy. The increased weight gain during pregnancy can lead to lower back pain.
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 To Treat Back Pain From Copd
If you have COPD and suffer from back pain, you don’t have to suffer in silence. There are many different options for treating back pain, including home treatment, medication, and implementing new habits in your daily life that support a healthy back.
Bad posture can both cause back pain and make existing back pain worse. It can cause muscle strain and stiffness, compress your bones and joints, and lead to variety of back aches and pains.
On the other hand, good posture supports your spine and the muscles in your back so they don’t get tired or strained. By adjusting your posture, you can relieve existing back pains and prevent more pain in the future.
People with COPD are particularly prone to bad posture because of their respiratory symptoms and tendency to avoid exercise. Because of this, it is particularly important for you to watch your posture if you suffer from COPD.
Sleeping posture, in particular, is a problem for many people with COPD. One reason for this is that lying down on your back puts extra weight on your chest, which makes it more difficult to breathe.
One solution to this is to sleep on your side, which many patients find makes it easier to breathe and sleep at night. However, to keep your spine aligned and prevent back pain, you should also put a small pillow between your knees.
To learn more about how your posture can affect your COPD, visit our guide on how to improve your COPD with good posture.
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How Is The Cause Of My Lower Back Pain Diagnosed
To determine the exact origins of your low back pain, a spine specialist provider at Neurosurgery One will take your medical history, ask you about the location, frequency, and duration of your pain, and perform a specialized physical exam. Depending on your symptoms, we may recommend an imaging test or scan, such as:
- Spine X-ray is used to identify degenerative disease, fractures, and tumors.
- CT scans of the spineproduce detailed, cross-sectional images of the spine, which can help detect subtle changes in bones.
- Spine MRI shows both tissue and bone and is useful in diagnosing a bulging, protruding, or herniated disc, or pinching of the nerves or spinal cord.
- Bone scans identify abnormalities of the bone, such as tumors or inflammation.
When Should I See A Doctor For Back Pain
When your back first starts to hurt, try taking an over-the-counter pain reliever and applying ice in the first 48 hours. You may apply heat after 48 hours. You may need to take it easy for a while, but its best to stay as active as tolerated, and to avoid absolute bed rest, said Dr. Guo.
If your back pain lasts more than two weeks and keeps you from participating in normal, daily activities, see your family doctor. If your pain is severe, you should see a doctor sooner. You should seek urgent medical care if you have:
- Fever associated with back pain
- Back pain after trauma
- Loss of bladder or bowel control
- Loss of strength in your arms and legs
- Unexplained weight loss associated with back pain
Also, always be more cautious if you have special risk factors for cancer, infection, or fractures that may affect the spine.
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How Can I Manage My Symptoms
- Apply ice for 15 to 20 minutes every hour, or as directed. Use an ice pack, or put crushed ice in a plastic bag. Cover it with a towel before you apply it to your skin. Ice decreases pain and helps prevent tissue damage.
- Apply heat for 20 to 30 minutes every 2 hours, or as directed. Heat helps decrease pain and muscle spasms.
- Use massage to loosen tense muscles. Massage may relieve back pain caused by tight muscles. Regular massages may help prevent this kind of back pain.
- Ask about acupuncture for pain relief. Back pain is sometimes relieved with acupuncture. Talk to your healthcare provider before you get this treatment to make sure it is safe for you.
There Has To Be Some Form Of Sure
Start by being a conscientious consumer.
Once reassured by your doctors that there is no fracture, infection, tumor, or a sinister medical condition that is responsible for your pain, the next step is to look for whether there are any factors that you can use to improve your pain condition.
Research shows back pain treatment to be one of the most-treated conditions in the United States. Consumers expectations are that this pain can be cured with a straightforward medication or procedure.
Think back to the concept that chronic back pain is coming from overactive nerve or pain sensors that are amplified by the spinal cord or brain. Unfortunately, we cannot get into your deep muscles and spinal cord to adjust your microscopic pain filters without harming their various other vital functions. Our approach is to help you address the root causes of your pain by focusing on muscle flexibility, strength, and endurance.
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One In Four Adults With Back Pain Is In Fair To Poor Physical Health
Compared to adults without back pain, larger proportions of adults with any type of back pain report fair to poor mental and physical health. For example, the proportion of adults with back pain reporting fair to poor physical health 25 percent is more than double that of those without back pain 11 percent .
Even Mild Chronic Pain Should Be Checked By Your Medical Specialist
Many people out there are suffering mild chronic pain and because it is bearable, they dont see a reason of visiting a doctor. It is, however, advisable to get back pain evaluated despite being mild. Any pain could be a sign of an underlying disease that needs to be treated. Early diagnosis and treatment of mild pain may help prevent it from becoming serious and hard-to-treat chronic back pain. Any kind of pain, therefore, needs to be taken seriously as most cases start as mild pain as it slowly sneaks up on you to become a serious and chronic pain.
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Family And General Practitioners
When your neck or back pain first starts, your family doctor, general practitioner , or primary care physician is probably your best bet. They may prescribe some painkillers, give you a few exercises to do, and possibly send you to a physical therapist.
If your doctor deems your problem a serious one, they will likely order diagnostic tests and/or refer you on to a specialist such as a rheumatologist or a neurologist. But family doctors can be slow to include new back treatments as they come out.
According to a 2006 study published in Spine Journal. Other than taking your medical history and giving you a physical exam, which are two staples of spine diagnosis, the study found that even as new recommendations were published by leading medical organizations, physicians did not adopt them into their practices.
Because of this, taking a pro-active approach when shopping for spine care may be helpful to you. One way to do this is to research possible diagnostic and treatment options before seeking the doctor. Asking pointed questions while you’re at your appointment is another way.
Why Go To An Orthopedic Doctor For Back Pain
Most us will experience back pain at some point in life. While most back pains resolve on their own or with conservative treatments, some need serious medical attention. Back pain may be a sign of a serious condition, and it will progressively get worse if left untreated.
If your back pain is not getting better and is limiting the activities you can engage in, see an orthopedic doctor. Why go to an orthopedic doctor for back pain? Why cant your primary care physician just treat it? Orthopedic doctors have specialized knowledge, training, and experience in diagnosing, treating, and preventing musculoskeletal pain. While a primary care physician can treat a plethora of health issues, an orthopedic doctor can do it better.
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Exercise: A Key Component Of Recovery
The role of physical exercise in resolving back pain cant be overstated. Many people with chronic back or neck pain stop their usual activities, thinking it might make their situation worse. However, according to new guidelines from The American College of Physicians, avoiding physical activity can lead to the atrophy of core and back muscles that support the spine.
It may seem paradoxical, but you should remain physically active when you are in pain, especially when you are in pain. According to the most up-to-date research, its the most effective way to resolve a back-pain episode.
Exercise is the key to undoing ingrained chronic pain pathways. Exercise creates new brain cells and neural pathways. It also stimulates blood flow, and has an anti-inflammatory effect on discs in the spine, says Dr. Isaac.
Other benefits of exercise for resolving chronic pain include improvements in:
- Muscle mass
- Strength, flexibility, balance and bone density
- Cardiac function and conditioning
