How Is Low Back Pain Diagnosed
Your doctor will likely begin by requesting a complete medical history and conducting a thorough physical examination to determine where youre feeling the pain. A physical exam can also determine if pain is affecting your range of motion.
Your doctor may also check your reflexes and your responses to certain sensations. This determines if your low back pain is affecting your nerves.
Unless you have concerning or debilitating symptoms or neurologic loss, your doctor will probably monitor your condition for a few weeks before sending you for testing. This is because most low back pain resolves using simple self-care treatments.
Certain symptoms require more testing, including:
- lack of bowel control
- fever
- weight loss
Likewise, if your low back pain continues after home treatment, your doctor may want to order additional tests.
Seek medical attention immediately if you experience any of these symptoms in addition to low back pain.
Imaging tests such as X-rays, CT scans, ultrasounds, and MRIs may be necessary so your doctor can check for:
- bone problems
- disc problems
- problems with the ligaments and tendons in your back
If your doctor suspects a problem with the strength of the bones in your back, they may order a bone scan or bone density test. Electromyography or nerve conduction tests can help identify any problems with your nerves.
The Healthline FindCare tool can provide options in your area if you need help finding a doctor.
Yoga: Stretching For Back Pain
If back pain doesn’t go away in three months, there’s evidence that yoga can help. In one recent study, people who took 12 weeks of yoga classes had fewer symptoms of low back pain than people who were given a book about care for back pain. The benefits lasted several months after the classes were finished. The study suggests conventional stretching also works just as well. Make sure your instructor is experienced at teaching people with back pain and will modify postures for you as needed.
Nonspecific Low Back Pain
This is the most common type of back pain. The majority of cases of sudden-onset low back pain are classed as nonspecific. This is the type of back pain that most people will have at some point in their lives. It is called nonspecific because it is usually not clear what is actually causing the pain. In other words, there is no specific problem or disease that can be identified as the cause of the pain. The severity of the pain can vary from mild to severe. This type of back pain is discussed further below.
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When To See A Specialist For Lower Back Pain
If you’re experiencing lower back pain that’s not responding to rest and self-care, it’s time to consider seeing a spine specialist.
“A spine specialist will likely perform a physical exam as well as one or more imaging scans to diagnose the root cause of your lower back pain. Depending on your diagnosis, he or she will then design a treatment plan aimed at alleviating your pain and preventing it from disrupting the everyday activities you enjoy,” says Dr. Palmer.
Is It Possible To Prevent Low Back Pain
Avoiding injury to the low back is a method of preventing low back pain. Additionally, conditioning exercise programs designed to strengthen the lumbar area and adjacent tissues can help to minimize risk of injury to the low back. Specific programs to relieve and prevent back pain can be designed with the help of physical therapists and other treating health care professionals.
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Choosing A Mattress That Can Help With Back Pain
With the right mattress, you can align your spine and relieve pressure points, which can alleviate or eliminate back pain. Thats why its important to choose a mattress that meets your needs for firmness, comfort, and support. When youre shopping for a bed that can relieve your back pain, consider these points:
Will Bed Rest Help Back Pain
Doctors often recommend continuing your usual activities of daily living as soon as possible. Studies suggest that strict bedrest can often prolong or worsen low back pain. Bed rest can also lead to secondary complications such as depression, decreased muscle tone, and blood clots in the legs. You should try and keep moving while avoiding activities that noticeably aggravate or worsen back pain. By staying active, those who suffer from low back pain can gain greater flexibility and quicker recovery.
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The Importance Of An Accurate Diagnosis
The physician will need to take a careful medical history and do a physical exam to look for certain red flags that indicate the need for an X-ray or other imaging test. In most cases, however, imaging such as X-ray, MRI , or CT scan is unnecessary.
There may also be certain clues in a patients medical history. Low back, nonradiating pain is commonly due to muscle strain and spasm. Pain that radiates into the buttock and down the leg may be due to , a condition in which a bulging disc presses on the sciatic nerve, which extends down the spinal column to its exit point in the pelvis and carries nerve fibers to the leg. This nerve compression causes pain in the lower back radiating through the buttocks and down one leg, which can go to below the knee, often combined with localized areas of numbness. In the most extreme cases, the patient experiences weakness in addition to numbness and pain, which suggests the need for quick evaluation.
A persistent shooting or tingling pain may suggest lumbar disc disease. A pain that comes and goes, reaching a peak and then quieting for a minute or two, only to reach a peak again, may suggest an altogether different cause of back pain, such as a kidney stone.
When tumor or infection are suspected, the doctor may order blood tests, including a CBC and sedimentation rate .
What Are The Warning Signs Of A Serious Problem
Very rarely back pain or pain that travels down the leg is a sign of a serious problem.
If you have any of the following symptoms, you should seek urgent medical attention:
- difficulty controlling or passing urine
- loss of control of your bowels
- numbness around your back passage or your genitals
- serious weakness in your legs so you find standing really difficult
- severe and ongoing back pain that gets worse over several weeks.
The above symptoms could potentially be linked to a rare but serious condition that needs urgent medical attention.
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Can I Prevent Back Pain
You may be able to prevent back pain that happens because of overuse or moving the wrong way. The following tips may help:
- Get regular exercise that keeps your back muscles strong. Exercises that increase balance and strength can lower your risk of falling and injuring your back or breaking bones. Your doctor may recommend that you try tai chi or yoga.
- Eat a healthy diet with enough calcium and vitamin D, which help keep your spine strong.
- Maintain a healthy weight to avoid stress and strain on your back.
- Sit up straight. Try to support your back when sitting or standing.
- If you have to lift something heavy, use your leg and stomach muscles, not your back.
What Are The Most Common Lower Back Surgery Procedures
Spine surgery is not necessary for most people who have lower back pain. If you do need it, your doctor will recommend an appropriate procedure to address your specific symptoms and medical situation. Common spine surgeries include:
Spinal Fusion. Two or more vertebrae are permanently fused together to limit excess spinal motion. Your surgeon will use a combination of bone, bonelike material, screws, plates and rods to hold the vertebrae together so they can heal into a single unit. Spinal fusion may be done to correct spinal deformities or to increase the spines stability in severe cases of spinal osteoarthritis or herniated discs.
Laminectomy and laminotomy. Laminectomy is a surgery in which your surgeon removes the back portion of one or more vertebrae to create more space for the spinal cord or other nerves. In people with severe arthritis, bone spurs within the spinal canal can grow large enough to press on the spinal cord, causing pain and limiting mobility. In a similar surgery known as laminotomy, your surgeon will remove a small piece of bone called the lamina from the back of the vertebra.
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Preventing Low Back Pain
Steps to lower your risk of back pain as you age include exercising regularly , maintaining a healthy weight, lifting with the legs and not the low back, and optimizing your workstation.
After any period of prolonged inactivity, a regimen of low-impact exercises is recommended. Speed walking, swimming, or stationary bike riding 30 minutes daily can increase muscle strength and flexibility and protect your low back from injury or strain. Frequent stretching can help loosen muscle tension, strengthen your core muscles, and improve over-all posture for a healthier back.
REFERENCES:
Back Pain Culprit: Your Bag
Although you may wear your purse, backpack, or briefcase over your shoulder, it is the lower back that supports the upper body — including any additional weight you carry. So an overstuffed bag can strain the lower back, especially if you carry it day after day. If you must tote a heavy load, consider switching to a wheeled briefcase.
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When Should I See My Healthcare Provider About Lower Back Pain
Lower back pain usually gets better with rest and pain relievers. Back pain that doesnt go away may be a sign of a more serious condition.
See your provider if you have:
- Pain that doesnt get better after about a week of at-home care.
- Tingling, numbness, weakness or pain in your buttocks or legs.
- Severe pain or muscle spasms that interfere with your normal activities.
- Fever, weight loss, bowel or bladder problems or other unexplained symptoms.
A note from Cleveland Clinic
Millions of people live with low back pain. Stiffness, pain and limited movement can have a major impact on quality of life. But you may be able to avoid lower back pain by maintaining a healthy weight and staying active. Talk to your provider if back pain doesnt go away or if youre unable to do the activities you enjoy. Several treatments can relieve pain, help you move better and get more out of life.
Last reviewed by a Cleveland Clinic medical professional on 01/18/2021.
References
Symptoms Of Low Back Pain
These might range from a dull ache to a stabbing or shooting sensation. The pain may make it hard to move or stand up straight. Pain that comes on suddenly is âacute.â It might happen during sports or heavy lifting. Pain that lasts more than 3 months is considered âchronic.â If your pain is not better within 72 hours, you should consult a doctor.
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Get Medication For Your Pain
Sometimes, the best treatment for back pain is medication. This is especially true for serious back injuries and many types of chronic back pain.
What kind of medication you need depends on the type of back pain you experience and how frequent and severe it is. Here’s a quick look at which medications work best for different types of back pain.
Drugs for Acute Back Pain
What kind of medication is appropriate for acute back pain depends mostly on how severe it is. Because acute pains tend to get better relatively quickly, you usually only have to take medication for a short time until your discomfort begins to improve.
If the acute back pain is only minor, then simple over-the-counter pain relievers should work well enough that no heavier drugs are needed. Medications like ibuprofen, Advil, Aleve, and topical creams can usually to do the trick.
If your pain is more severe or over-the-counter medications aren’t effective, you should see your doctor to get an evaluation. If the cause is muscular, your doctor might prescribe muscle relaxants, which are very effective at relieving back muscle pain.
If you experience severe back pain, your doctor might prescribe you a heavier painkiller like an opiate. Although they can cause side effects and be highly addictive, they can be very effective for short periods to help you get through the worst of the pain.
Drugs for Chronic Back Pain
Drugs for Inflammation and Arthritis-related Back Pain
Chronic Conditions That Cause Back Pain
Conditions that can lead to chronic low back pain include spinal stenosis, spondylitis, and fibromyalgia. Spinal stenosis is narrowing of the normal spinal canal through which the spinal cord passes. Spondylitis is chronic inflammation of the spine. Fibromyalgia is a muscle disorder that features chronic muscle pain and tenderness.
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How Can I Prevent Low Back Pain
You can prevent low back pain with physical therapy, exercises, and stretching. Supports and back belts do not prevent low back pain.
Keep in shape, lose weight if you are overweight, and exercise regularly. Being inactive can lead to low back pain. Regular exercise like walking, swimming, or biking is good for your back. These activities put less stress on your back than sitting and standing.
Don’t lift heavy objects by bending over at the waist. Bend your hips and knees and then squat to pick up the object. Keep your back straight and hold the object close to your body. Don’t twist your body while you are lifting.
If you have to sit at your desk or drive for a long time, take breaks to stretch.
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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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.
Living With Lumbar Strain
Cold reduces swelling. Both cold and heat can reduce pain. Protect your skin by placing a towel between your body and the ice or heat source.
- For the first few days, apply an ice pack for 15 to 20 minutes.
- After the first few days, try heat for 15 minutes at a time to ease pain. Never sleep on a heating pad.
- Over-the-counter medicines can help control pain and swelling. Try aspirin or ibuprofen.
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Lower Back Pain: What Could It Be
Do you have lower back pain? You are not alone. Anyone can experience lower back pain at any time, even if you dont have a prior injury or any of the risk factors. It is not always serious and can often get better on its own. But in some cases pain is your bodys way of telling you that something isnt right.
Learn more about lower back pain and what causes it from rehabilitation physician Akhil Chhatre, M.D., who specializes in back pain in the Johns Hopkins Department of Physical Medicine and Rehabilitation.
What Are Some Complementary Alternative And Emerging Treatments For Lower Back Pain
In some cases, doctors suggest therapies that are not considered standard of care. They probably wont be covered by insurance, but they may be worth considering. Examples include:
Platelet-rich plasma . PRP treatments use a small sample of your own blood that has concentrated amounts of blood building blocks known as platelets. Your doctor then injects the PRP directly into a damaged disc. The theory is that PRP injections use your own healing system to accelerate improvement of injured tendons, ligaments, muscles, and joints. PRP treatment has a longer track record in knee osteoarthritis, but a recent review article in the Journal of Spine Surgery suggests it may have a useful role for back pain, too. PRP needs a lot more research before it can be considered a proven technique.
Stem cells. In this emerging treatment, your doctor injects stem cells harvested from your hip into the intervertebral disc or discs causing your pain. Doing so may lessen pain and the degenerative effects of aging, though, like PRP, more research is needed before stem cells for lower back pain could eventually become the standard of care.
Acupuncture. Your doctor probably doesnt perform acupuncture , but may support you trying it as a complementary therapy. Acupuncture involves careful insertion of fine, sterile needles into specific points on your body. This may stimulate the release of your natural pain-killing chemicals.
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