What To Do About Severe Lower Back Pain
If you have severe back pain, connect with a doctor as soon as possible.
You may discuss diagnostic tests if a healthcare professional hasnt already identified the cause of your back pain. After you receive a diagnosis from the doctor, youll discuss treatment options.
If your lower back pain is accompanied by a loss of bowel or bladder control, or progressive neurological loss, seek immediate medical attention. You might need emergency surgery.
There are many ways to prevent lower back pain. Taking these measures may help prevent pain altogether or lessen the severity of your symptoms if you manage to get injured.
Prevention may involve:
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.
Can Lower Back Pain Be A Sign Of Something Serious Like Cancer
Lower back pain can be related to cancer. In fact, it is one of the first symptoms of prostate cancer when it metastasizes and creates lesions. Almost any cancer can spread to the back and some, like sarcoma, can originate in the back. Be cautious, especially if you are experiencing other symptoms besides lower back pain. Talk to your doctor if you have additional symptoms or concerns.
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How Your Back Works
The spine, which is also called the backbone or spinal column, is one of the strongest parts of the body and gives us a great deal of flexibility and strength.
Its made up of 24 bones, known as vertebrae, one sitting on top of the other. These bones have discs in between and lots of strong ligaments and muscles around them for support. There are also the bones in the tailbone at the bottom of the back, which are fused together and have no discs in between.
On either side of the spine, running from top to bottom, are many small joints called the facet joints.
The spinal cord passes inside the vertebrae, which protect it.
The spinal cord connects to the brain through the base of the skull and to the rest of the body by nerves that pass through spaces between the bones of the spine. These nerves are also known as nerve roots.
As you grow older, the structures of your spine, such as the joints, discs and ligaments, age as well. The structures remain strong but its usual for your back to get stiffer as you get older.
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.
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Nonsurgical Treatments To Help You Stand Straighter And Longer Without Pain
The talented team of professionals at Long Island Spine Rehabilitation Medicine can design a treatment program especially for you that may include one or more of the following injection approaches or interventions. It should be noted that very often such pain complaints can be successfully treated without any type of injection procedure as the judicious use of medications and a personalized physical rehabilitation program may well suffice:
- Spinal epidural injections administered under fluoroscopic guidance to target the site of your pain
- Facet joint injections to address painful joints of the spine for diagnostic and therapeutic purposes and possibly radiofrequency denervation to address the nerves which carry pain signals from the painful segments
- Acupuncture in which tiny needles are inserted painlessly into the skin to increase energy flow and release endorphins that act as natural painkillers
- PEMF technology that uses varying frequencies of electromagnetic waves to diminish or eliminate back pain and accelerate healing
One of our experienced physiatrists can diagnose the cause of your pain precisely and prescribe a physical therapy program that will strengthen your back without doing you any harm. He or she can also provide a broad range of treatment options that may help to resolve your lower back issues so that you can once again enjoy socializing at parties or social events without being the person who always has to sit down.
What You Need To Do Back Pain Relief
- Reduce the inflammation:
- Either take an anti-inflammatory medication . GP prescription may be required.
- If it is too painful even to go see the GP,
- Apply a COLD press to the sore/painful area.
- Take an over-the-counter anti-inflammatory . This is a weaker form of anti-inflammatory medication than what you will get from your GP.
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I Didnt Need Exercise Before And I Dont Now
The problems with your symptoms are not obvious until long after some injury has occurred to you. There is a good chance that earlier warning signs such as sudden spasm, stiffness, soreness, tightness and aches are sometimes seen as unrelated or to be treated simply with rest or medication.
But when you are not able to care for yourself because of these warning signs, they may progress into the morning. Sudden and gradual changes to your level of activity or lifestyle do have an impact on any changes to the overall health of your back.
Dont regard exercise as something new to add to your recovery. Rather, it should be seen as what your body naturally requires to maintain optimal health and protection of your spine. The type of exercises for your relief that are beneficial are actually composed of movements and stretches to improve your mobility and eliminate weaknesses.
How To Sit On A Chair
To sit on a chair safely:
To help your back and make sitting more comfortable:
- Try to get up and change position regularly
- Try to sit right back in the chair
- Put a rolled up towel in the small curve at the bottom of your spine
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Complementary And Alternative Techniques Include:
- Acupuncture is moderately effective for chronic low back pain. It involves inserting thin needles into precise points throughout the body and stimulating them , which may cause the body to release naturally occurring painkilling chemicals such as endorphins, serotonin, and acetylcholine.
- Behavioral approaches include:
- Biofeedback involves attaching electrodes to the skin and using an electromyography machine that allows people to become aware of and control their breathing, muscle tension, heart rate, and skin temperature people regulate their response to pain by using relaxation techniques
- Cognitive therapy involves using relaxation and coping techniques to ease back pain
Spinal injections include:Trigger point injections can relax knotted muscles that may contribute to back pain. An injection or series of injections of a local anesthetic and often a corticosteroid drug into the trigger point can lessen or relieve pain.
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How Is Sciatica Treated
The goal of treatment is to decrease your pain and increase your mobility. Depending on the cause, many cases of sciatica go away over time with some simple self-care treatments.
Self-care treatments include:
- Appling ice and/or hot packs: First, use ice packs to reduce pain and swelling. Apply ice packs or bag of frozen vegetables wrapped in a towel to the affected area. Apply for 20 minutes, several times a day. Switch to a hot pack or a heating pad after the first several days. Apply for 20 minutes at a time. If youre still in pain, switch between hot and cold packs whichever best relieves your discomfort.
- Taking over-the-counter medicines: Take medicines to reduce pain, inflammation and swelling. The many common over-the-counter medicines in this category, called non-steroidal anti-inflammatory drugs , include aspirin, ibuprofen and naproxen . Be watchful if you choose to take aspirin. Aspirin can cause ulcers and bleeding in some people. If youre unable to take NSAIDS, acetaminophen may be taken instead.
- Performing gentle stretches: Learn proper stretches from an instructor with experience with low back pain. Work up to other general strengthening, core muscle strengthening and aerobic exercises.
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Complementary Alternative Emerging Treatments
In some cases, doctors suggest therapies that are not considered current standard of care. They probably wont be covered by insurance, but they may be worth considering. Examples include:
. 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.
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.
. 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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Getting Out Of Bed Improperly
How a person gets out of bed can be vital to preventing early morning aches and pains. Even if a person is well-rested, rising too quickly or bending too far forward when getting out of bed can place a strain on the back.
To reduce the risk of morning back pain and stiffness, a person should follow these steps:
- Begin by moving slowly to the edge of the bed.
- Using the arms for leverage, transfer to a sitting position with the legs dangling off the side of the bed.
- After taking a few seconds to adjust to this position, slowly place the feet on the floor and stand up.
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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.
What Are The Risk Factors For Developing Low Back Pain
Anyone can have back pain. Factors that can increase the risk for low back pain include:
Age: The first attack of low back pain typically occurs between the ages of 30 and 50, and back pain becomes more common with advancing age. Loss of bone strength from osteoporosis can lead to fractures, and at the same time, muscle elasticity and tone decrease. The intervertebral discs begin to lose fluid and flexibility with age, which decreases their ability to cushion the vertebrae. The risk of spinal stenosis also increases with age.
Fitness level: Back pain is more common among people who are not physically fit. Weak back and abdominal muscles may not properly support the spine. Weekend warriorspeople who go out and exercise a lot after being inactive all weekare more likely to suffer painful back injuries than people who make moderate physical activity a daily habit. Studies show that low-impact aerobic exercise can help maintain the integrity of intervertebral discs.
Weight gain: Being overweight, obese, or quickly gaining significant amounts of weight can put stress on the back and lead to low back pain.
Genetics: Some causes of back pain, such as ankylosing spondylitis , have a genetic component.
Smoking: It can restrict blood flow and oxygen to the discs, causing them to degenerate faster.
Backpack overload in children: A backpack overloaded with schoolbooks and supplies can strain the back and cause muscle fatigue.
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When To Contact A Medical Professional
Contact your provider right away if you have:
- 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 contact your provider 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
Diagnosing Lower Back Pain
To diagnose lower back pain, a doctor will first do a physical exam. Theyll look at how well you move and if your back has any visible issues.
Then theyll take a medical history. This will cover your symptoms, any recent injuries, previous back issues, and the severity of your pain.
A physical exam and medical history are often enough for a doctor to determine the cause of your pain. However, they may also need to do an imaging test. Potential tests include:
- X-ray, which can find broken or misaligned bones.
- CT scan, which shows soft tissues such as the discs between vertebrae and potential tumors
- myelogram, which uses dye to enhance the contrast in a CT scan or X-ray to help a doctor identify nerve or spinal cord compression
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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.
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What Complications Are Associated With Sciatica
Most people recover fully from sciatica. However, chronic pain can be a complication of sciatica. If the pinched nerve is seriously injured, chronic muscle weakness, such as a drop foot, might occur, when numbness in the foot makes normal walking impossible. Sciatica can potentially cause permanent nerve damage, resulting in a loss of feeling in the affected legs. Call your provider right away if you lose feeling in your legs or feet, or have any concerns during your recovery time.
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