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Why Do I Have Severe Back Pain

The Most Common Causes Of Lower Back Pain Are A Strain Or Sprain

Why do you have Low Back Pain?

Whether you notice it or not, your lumbar spine gets put to work throughout the entire day.

Amid all of this work and motion, a lower back sprain or strain can result from an acute injury, such as one experienced while falling, lifting something too heavy or playing sports. A sprain or strain can also develop over time due to repetitive movements or poor posture.

“Straining a muscle or spraining a ligament are the most common causes of lower back pain,” says Dr. Palmer. “While they can be serious, these common causes of lower back pain aren’t long-lasting taking anywhere from a few days to heal or, at most, a few months.”

Your doctor can help you determine the particular course of self-care that can help heal your lower back pain.

“The treatment for a pulled back muscle or strained back ligament is fairly simple and can include pain and anti-inflammatory medications, muscle relaxers, ice to help reduce inflammation, heat to promote healing, and avoiding strenuous activity until the pain recedes,” explains Dr. Palmer. “The best course of care will depend on the severity of your injury as well as your overall core and lower body strength.”

If your lower back pain persists despite treatment, it may be time to consider other causes of lower back pain.

Is Your Back Pain An Emergency

Did you wake up today with the worst back pain youve ever felt?

Was it a normal day, and then severe back pain started and you dont know what to do?

In these circumstances you might think the emergency room is the place to go for help.

There are certain pain symptoms that do belong in the emergency department:

  • If you have severe pain anywhere, with vomiting, nausea, fever or changes to your consciousness call an ambulance and get medical care. The medical system is designed to help with symptoms like these.
  • If you have had trauma. If you have a fall, a car accident, you hit your head, slipped down the stairs, crashed your bike and you have pain and symptoms like above, you should call an ambulance and make sure youre safe.
  • If you have severe back pain, lose control of your bladder or bowels, and lose power and feeling in your legs, you should also go to the emergency room.
  • Severe back pain is rarely a medical emergency. Back pain, even with tingling or numbness in your leg, pain that makes you limp, and hurts to sit or stand for long doesnt belong in the emergency room.

    You’re Having Problems With Your Bowels Or Urination

    If your back pain is paired with a loss of control over your bowels or urination, then it’s time to seek help immediately at a local emergency room. These symptoms point to cauda equina syndrome, where the nerves in the lower spine have become paralyzed. While rare, this syndrome can be permanently damaging to the nerves if left untreated. If you experience these symptoms, especially accompanied by numbness in the legs, then you may need surgery to decompress the nerves and preserve their overall function.

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    When To See A Doctor

    Even though it’s common, most cases of back pain tend to clear up without the need to see a doctor.

    You should see your doctor if your pain:

    • is really bad
    • lasts for a long time
    • stops you from working or doing the things you enjoy
    • affects your everyday activities
    • gets worse.

    You should also see your doctor if you have any changes in sexual function, for example, being unable to get an erection.

    If the pain is causing you significant problems and stops you from getting on with normal life and work activities, your doctor will examine you and ask you questions.

    These questions will help predict how likely it is that you need further help with your back pain. If you do need further support, your doctor will make a referral to physiotherapy so that you can have treatment early, to help with the pain and return to normal activities.

    Its natural to want to know what has caused your back pain. However, specialists may not be able to tell you for certain what has caused your back pain, even after carefully assessing you.

    If youre concerned about the cause of your back pain, it can help to talk openly about any worries with a healthcare professional, as reducing any fear may help speed up your recovery.

    Muscle Deconditioning And Poor Posture

    Two Common Lower Back Pain Causes...And What to do About Them

    People can condition their muscles over time to be stronger or more enduring through exercises and weight training.

    The reverse is also true. Humans may decondition their muscles over time by not using them correctly.

    In some muscles, including back muscles, deconditioning is as easy as sitting at a desk with incorrect posture for too long. A person may do this while at work.

    Slouching in a chair over a desk may cause a loss of strength in the muscles. Over time, the weakening of muscles may lead to pain in the area as they experience strains or irritation.

    When a person slouches, pressure from gravity and the body itself pushes on the spine, neck, discs, and ligaments. Over time, this pressure can lead to pain and other complications.

    It is possible to condition the muscles to be stronger and more durable in most cases. This process starts with correcting the posture while sitting, and taking regular breaks from the desk to move around and stretch.

    Exercises may also improve strength in the back, and using a standing desk can help, too.

    Conditioning the muscle requires patience, however, and anyone with chronic upper back pain from weak muscles might benefit from seeing a physical therapist to find an exercise routine for their specific needs.

    Also Check: Exercise For Lower Back Pain Mayo Clinic

    Lower Back Pain: Is It In Your Genes

    One of the main reasons a person develops low back pain and another doesn’t may lie in their genes. With disc degeneration, Andersson says, âIf you take twins — one who is doing heavy physical work and one who is doing desk work — and you compare their MRI exams, they are essentially identical. This tells you that genetic factors are very important.â

    If you have chronic low back pain, you’ve likely inherited the tendency, and you’re probably hardwired for it. The lower back contains sensitive receptors called nociceptive fibers, which send pain signals to the brain. “Some people have a lot of nociceptive fibers — for example, in their discs — while others have relatively few,” Wisneski tells WebMD. That may be why one person can lift heavy weights many times and never experience low back pain, while another who barely lifts anything is in constant agony.

    Two Back Pain Situations You Should Take Seriously Right Away No Delay

    These two back pain scenarios might be medical emergencies. They do not necessarily mean something horrible is wrong, but its important to make sure.

  • Pain and weakness in both legs, especially if its also hard to pee. More about this below.
  • Any accident with forces that may have been sufficient to fracture your spine. Please seek thorough medical assessment promptly, including an X-ray to look for a fracture. You really do need an X-ray to ensure that your spine is not actually broken. They arent necessarily as obvious as youd think!12
  • Isnt it rather obvious that a potential spinal fracture is an emergency?

    Youd think so. But consider this story of a motorcycle accident: many years ago, a friend hit a car that had pulled out from a side street. He flew over the car & landed on his head. Bystanders showed their ignorance of spinal fracture by, yikes, carelessly moving him. In fact, his thoracic spine was significantly fractured yet the hospital actually refused to do an X-ray because he had no obvious symptoms of a spinal fracture. Incredible! The next day, a horrified orthopedic surgeon ordered an X-ray immediately, confirming the fracture & quite possibly saved him from paralysis.

    Pain + weakness in both legs as symptoms of cauda equina syndrome or not

    That said, obviously you should be checked out if you are experiencing true saddle numbness.17 Even if its not CES, any significant malfunction of your plumbing should be taken seriously.

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    Sensations That Might Indicate A Medical Emergency

    1. Sharp pain rather than a dull ache: This could indicate a torn muscle or ligament, or a problem with an internal organ in the back or side.2. Radiating pain: This pain “moves” or shoots to the glutes or legs, which could indicate a nerve compression condition.

    3. Sudden weakness in the legs: Limb weakness can be caused by compressed nerves in the spine due to conditions like sciatica or spinal stenosis. However, sudden leg weakness could also indicate a stroke.4. Incontinence: Back pain paired with inability to control the bowels or bladder might be a sign of serious nerve compression or a spine infection, such as discitis or meningitis.5. Numbness or pins and needles in the groin or glutes: This is known as saddle anesthesia and is also a sign of a serious nerve or spine condition.

    If you have leg weakness, incontinence, and numbness together, you might have cauda equina syndrome, a serious illness characterized by spinal cord nerve damage. This is a medical emergency, and patients usually need surgery immediately to decompress the nerves and reduce permanent damage.

    Related reading: Get help for back, neck, and leg pain caused by spinal stenosis

    The Ache Wont Go Away

    Why do I have back pain on my period?

    Youve tried the DIY treatments, gotten massages, and maybe even bought a new mattress. If your upper back is persistently hurting, it mayvery rarelybe a sign of a lung tumor. The American Cancer Society points out that advanced lung cancer may contribute to bone pain. Weight loss, chest pain, and weakness are also signs of lung cancer.

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    How Is Chronic Back Pain Diagnosed

    Your healthcare provider will ask if you have any medical conditions. He or she may ask if you have a history of back pain and how it started. He or she may watch you stand and walk, and check your range of motion. Show him or her where you feel pain and what makes it better or worse. Describe the pain, how bad it is, and how long it lasts. Tell your provider if your pain worsens at night or when you lie on your back.

    Persistent Low Back Pain

    Nonspecific low back pain is classed as chronic if it lasts for longer than six weeks. In some people it lasts for months, or even years. Symptoms may be constant. However, the more usual pattern is one in which symptoms follow an irregular course. That is, reasonably long periods of mild or moderate pain may be interrupted by bouts of more severe pain.

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    What Does It Mean If Lower Back Pain Is Shooting Into Legs

    Lower back pain can radiate to other parts of the body: up or down from its place of origin. Sometimes lower back pain can be on one side of the back, which is also normal.

    If the pain is shooting from the lower back into one or both legs, it could be sciatica , but its not always the case. There are many parts in the lower back that may cause the pain to radiate into the legs, such as facet joints, sacroiliac joints, muscles or inflammation of the bursa.

    It May Be Your Desk Job

    DIY Lower Back Pain Relief Exercises and Education from a Professional ...

    Slouch much? Upper back pain is most commonly from poor posture, says Irene Tien, MD, emergency medicine physician with the Rowe Telemedicine Network. Sitting and staring at a computer shortens chest muscles and pulls on the muscles in the upper back. A lot of people get a muscle spasm between the shoulder blades as a result, she explains. Heres how to help your body recover from sitting all day long.

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    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.

    Whenback Pain Is Likely Spinal Stenosis

    Spinal stenosis is one of themost common causes of spinal pain not related to injury. This narrowing of thespace around the spinal cord puts pressure on the nerves. If you have thefollowing symptoms, spinal stenosis may be to blame:

    • A heavy feeling in the legs, which may lead to trouble walking.
    • Increased pain going downhill.
    • Symptoms that get worse with activity.
    • Relief from the grocery cart position bending forward like youre leaning on a shopping cart.

    However, Dr. Khalaf notes howcommon false positives are. Around 21% of asymptomatic people over age 60will show signs of spinal stenosis on an MRI, she says. And sometimes spinalstenosis and peripheral arterial disease co-exist. Thats why you need aphysical exam, and possibly other tests, to get a clear diagnosis.

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    Chronic Or Acute Pain

    • Acute pain starts suddenly and lasts for up to 6 weeks.
    • Chronic or long-term pain develops over a longer period, lasts for over 3 months, and causes ongoing problems.

    If a person has both occasional bouts of more intense pain and fairly continuous mild back pain, it can be hard for a doctor to determine whether they have acute or chronic back pain.

    Back pain usually resolves with rest and home remedies, but sometimes medical treatment is necessary.

    What Causes Gas To Get Trapped

    Why do I have lower back pain?

    Gas has both external and internal causes, according to Neil Gupta, MD, an associate professor of gastroenterology and regional director of digestive health at Loyola University Medical Center in Maywood, Illinois.

    And when that gas gets stuck in your intestines, pain can ensue. “Trapped gas can cause cramping or bloating anywhere along your digestive system,” he says. “Gas pain can be felt in your upper back when is trapped in a part of your colon in the back of your abdomen called the retroperitoneum.”

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    What To Do If You Suspect Something Else

    Theres only one major tiphere: See a doctor, whether it is your primary care physician or aspecialist. Each condition that mimics spinal problems comes with its own treatments,but the first step is an accurate diagnosis. For example, a nerve test such aselectromyography can help a doctor spot neuropathy, and a blood-flow testsuch as the ankle-brachial index can distinguish between spinal stenosisand peripheral arterial disease.

    Its so important to look atall of your symptoms and history and do a thorough examination, Dr. Khalafsays. Its how we can tell the difference between a back issue and a medicalcondition.

    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.

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    Age And Gender Issues

    Age and gender are important factors to consider when diagnosing low back pain. In a young patient, a benign tumor of the spine called an osteoid osteoma may be the culprit. Inflammatory bowel disease in young people can be connected with spondylitis and sacroiliitis . Low back pain from disc disease or spinal degeneration is more likely to occur as people get older. Conditions such as abdominal aneurysm or multiple myeloma are also considered in older individuals.

    Osteoporosis and fibromyalgia are much more common triggers of back pain in women than in men. Osteoporosis is a progressive decrease in bone density that leaves the bones brittle, porous and prone to fracture. Fibromyalgia is a chronic disorder that causes widespread musculoskeletal pain, fatigue, and multiple tender points in the neck, spine, shoulders, and hips.

    Whenyour Back Pain Could Be A More Serious Medical Problem

    Why do I have lower back pain on my right side?

    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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