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.
Complete Guide To Low Back Pain
This article might ease your mind, but what about your back pain? If your pain is becoming chronic , or if you just keep having flare-ups, you may want to dive much deeper into the topic. There arent any easy answers for stubborn back pain, but there is evidence-based hope, and the PainScience.com back pain tutorial explores the topic extremely thoroughly. The main text is written for patients, but its also extensively referenced for keen readers and healthcare professionals. Read the introduction.
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.
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Referred Pain To And From 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.. Sources of referred pain to the low back 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. On the other hand, pain can be referred from the low back and be felt in another location, as is often the case with . For example, it is not rare for a patient with a slipped disc in the lower back to have pain in the back of the thigh, or in the calf or even the foot, and not have any low back pain. This situation requires a doctor to sort out the type of pain and to do the examination required to show that the pain is actually coming from the spine .
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.
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What Type Of Doctor Should I See For Back Pain
This depends on your condition or symptoms. If you have no obvious injury that would explain your pain, you may want to start by seeing a . This is a specialist in physical medicine who can diagnose back pain and determine whether nonsurgical treatments such as physical therapy may help. Depending on those findings, a physiatrist may also refer you to a , doctor or other type of back specialist, , for additional discussion.
Signs Your Back Pain Might Be An Emergency
In our 20s and 30s, normal back pain often can be attributed to factors of daily life, such as sitting too long, picking up children, or overdoing it while exercising.
In our 40s and older, work injuries and the beginnings of arthritis and degenerative conditions are more common.
Back pain is so common, in fact, that many patients shrug off symptoms that might indicate a medical emergency.
Approximately 80% of adults will experience back pain in their lives, so its important to be able to identify the severity of your symptoms and track how long the pain lasts.
If back pain can be associated with a specific activity, such as lifting or twisting wrong, and the pain goes away within 72 hours after resting and applying ice, its usually nothing to worry about. However, if pain creeps on gradually, appears suddenly, or doesn’t go away, you might have a more serious condition.
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Living With Back Pain
Living with back pain can be hard however, most people feel better within 6 weeks. Remember to follow your doctors directions. These tips may make it easier for you to manage your pain and recover:
- Add exercises slowly and talk to your doctor about the types of exercises that are best for you or those that you should not do.
- When sitting for a long time, get up, move around, and switch positions frequently.
- Wear shoes that feel good and that have a low heel.
- When driving a long way, try using support behind your back, and stop frequently to stand up and walk around.
- Sleep on your side, and place a small pillow between your knees. If you tend to sleep on your back, place a pillow under your knees. If possible, try to avoid sleeping on your stomach.
- Limit the amount you carry. Instead, make a few extra trips to avoid carrying too much weight.
Pelvic Floor Dysfunction Causing Chronic Low Back Pain
The missing piece is often the pelvic floor and pelvic floor dysfunction this is the reason the pain won’t go away.
Muscles that attach to and support your pelvis and tailbone include back muscles, abdominal muscles, glutes and other hip muscles, as well as a small set of muscles at the base called your pelvic floor. If your pelvic floor is not getting assessed and treated, you are missing a huge piece of the puzzle that is chronic low back pain.
These pelvic floor muscles are secondary stabilizers for the back, and often spring into action when the back is in pain. They can then be actually CAUSING more pain themselves, and are the reason orthopedic treatment doesn’t “stick.”
As pelvic floor physical therapists, weve always known there is a close relationship between the pelvic floor and low back pain. For many of our patients, one of the first symptoms they notice is sciatica or other low back pain often, they dont realize it might be related to their pelvic floor until their initial evaluation. Recent research has shown this is even more prevalent that we realized.
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Is Back Pain A Symptom Of Long
Long-haul COVID, also known as long COVID and post-COVID conditions, is a broad term used to describe new, returning, or ongoing health problems people can experience four or more weeks theyve first been infected with SARS-CoV-2, the virus that causes COVID-19, according to the Centers for Disease Control and Prevention .
Researchers and doctors are still learning about long COVID but the CDC says the following are some of the more common symptoms of the condition:
· Difficulty breathing or shortness of breath
· Tiredness or fatigue
· Symptoms that get worse after physical or mental activities
· Difficulty thinking or concentrating
· Change in smell or taste
· Changes in menstrual period cycles
While the list doesnt explicitly mention back pain, joint or muscle pain definitely is a broad category that can encompass it. Some people with long COVID report chronic pain, says infectious disease expert Amesh A. Adalja, M.D., a senior scholar at the Johns Hopkins Center for Health Security. But its unclear whether this is actually more common in long COVID patients because most studies do not have control groups.
Other Conditions That Cause Back Pain In Older Adults
We often see a range of less serious but still painful spine conditions in seniors. Most patients with these conditions will not require surgery. Physical therapy, medication, injectable anesthetics, or a combination of treatments usually can control symptoms.
- Degenerative disc disease, which can cause whole spine pain, and lumbar arthritis, which usually causes low-back pain, commonly develop with age and are considered wear-and-tear conditions.
- Sacroiliitis is an inflammation of the joints that connect your spine and pelvis. This condition can cause pain in the low back, glutes, and upper legs.
- Ankylosing spondylitis is an inflammatory arthritis that causes patients spines to become inflexible, resulting in a continual hunched forward position and spine pain.
- We also check for adult degenerative scoliosis and kyphosis, spine-curving conditions that can result in back pain and weakness in the lower extremities.
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Back Pain Culprit: Chronic Conditions
Several chronic conditions can lead to low back pain.
- Spinal stenosis is a narrowing of the space around the spinal cord, which can put pressure on the spinal nerves.
- Ankylosing spondylitis inflames the joints of the spine, and sometimes the shoulders, hips, ribs, and other areas too. It causes chronic back pain and stiffness. In serious cases, spinal vertebrae start to fuse .
- Fibromyalgia causes widespread muscle aches, including back pain.
Why Does My Lower Back Hurt When I Stand Too Long
While there are many underlying reasons for back pain during prolonged standing, the precipitating cause is usually postural. When you stand for a length of time, your pelvis is often pushed backward, increasing the curve of your lower back . This puts increased pressure on the soft tissues surrounding the spine, causing your lower back muscles to tighten or even spasm, resulting in pain in the joints and nerves of your spine.
At Long Island Spine Rehabilitation Medicine, we have a strong track record of diagnosing the causes of back pain accurately and treating them successfully without surgery. Our pain management doctors help patients feel more comfortable and move more easily whether their back pain is due to injury, aging, congenital malformations, or a disease condition. If you experience pain when standing or walking, we can evaluate your problem and offer you a variety of treatment options.
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Muscle Strain And Ligament Sprain
A low back sprain or strain can happen suddenly, or can develop slowly over time from repetitive movements.
- Strains occur when a muscle is stretched too far and tears, damaging the muscle itself.
- Sprains happen when over-stretching and tearing affects ligaments, which connect the bones together.
For practical purposes, it does not matter whether the muscle or ligament is damaged, as the symptoms and treatment are the same.
Common causes of sprain and strain include:
- Lifting a heavy object, or twisting the spine while lifting
- Sudden movements that place too much stress on the low back, such as a fall
- Poor posture over time
- Sports injuries, especially in sports that involve twisting or large forces of impact
While sprains and strains do not sound serious and do not typically cause long-lasting pain, the acute pain can be quite severe.
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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Does Pelvic Floor Dysfunction Or Back Pain Come First
Its not always clear which comes first. A major role of the pelvic floor is to help stabilize the core and lower back, so when the back is in pain, the pelvic floor muscles may tighten to try and protect the sensitive area. This can overwork the pelvic floor, causing trigger points to form in the muscles and creating additional symptoms . In other cases, the pelvic floor dysfunction may have come first and altered the spine’s mobility and stability, thus triggering low back pain. Either way, there is a feedback loop where low back pain and pelvic floor dysfunction reinforce each other. Both must be addressed for full resolution of symptoms.
What Are The Causes Of Lower Back Pain
The vast majority of patients experience back pain because of mechanical reasons. They strain a muscle from heavy lifting or twisting, suffer a sudden jolt in a car accident, experience stress on spinal bones and tissues resulting in a , or suffer from osteoarthritis, a potentially painful degeneration of one or more spinal joints. Common causes for low back pain are:
- mechanical or functional injury
- active infection
- referred pain
To choose the safest and most effective therapy, doctors need to consider the full spectrum of possible underlying issues, such as inflammatory conditions, fracture, infection, as well as some serious conditions unrelated to the back that radiate pain to the back.
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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.
What Are The Symptoms Of Lower Back Pain In Women
Pain in the lower back area can be acute or chronic . Paying attention to all symptoms you experience at the time can make management significantly easier. Symptoms of lower back pain in females depend on the cause.
As shown above, causes of pain in this area are numerous. In most cases, an affected person experiences a combination of the following symptoms:
- Dull or aching pain: refers to the pain that remains in the low back area. Pain can be stinging, burning, or sharp and it is usually accompanied by muscle spasms, pain in pelvis and hips, and decreased range of motion
- Pain feels better when changing positions: patients usually discover that some positions only enhance the pain in lower back while other positions alleviate it
- Pain gets worse after prolonged sitting: this symptom occurs in most cases of low back pain because sitting puts pressure on discs in your spine
- Pain is worse after waking up: a vast majority of patients who experience lower back pain report the discomfort is enhanced the first thing in the morning. However, pain decreases after getting up and moving
- Pain traveling to butt, legs, and feet: in some instances the pain doesnt remain in low back area, but it travels through your buttons down the legs and feet i.e. you experience symptoms of sciatica
If your lower back pain is accompanied by the following symptoms, you should seek immediate care:
- Fever and chills
- Loss of bowel and bladder control
- Severe abdominal pain
- Reproductive organs
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