How Long Does Lower Back Pain Last & What To Do For It
Lower back pain is a condition that affects so many people. It is estimated that about 80% of adults do suffer from lower back pain at some point of their lifetime. This problem is a work related disability and a major cause of absenteeism in most working places. Lower back pain affects both genders and can be felt in different intensities ranging from dull persistent pains to sharp pains that can immobilize a person.
Factors like accident, age, lifting of heavy materials and sedentary lifestyles can cause lower back pains. However, a bigger percentage of low back pain is termed as mechanical and is linked to Spondylosis which is the general degeneration of the spine in connection to wear and tear in bones, discs and joints as you grow old.
Here’s Something Completely Different For Low Back Pain
- By Robert H. Shmerling, MD, Senior Faculty Editor, Harvard Health Publishing
Its a question that has challenged generations of patients and their doctors. The answer has changed over the years. When I was in medical school in the early 1980s, bedrest for a week or more was often recommended for severe back pain. This sometimes included hospital admission. Then, research demonstrated that prolonged bedrest was actually a bad idea. It was no better than taking it easy for a day or two followed by slowly increasing activity, including stretching and strengthening the back.
Medications, including pain relievers, non-steroidal anti-inflammatory drugs , and muscle relaxants were a standard part of the initial treatment of back pain. But, recommendations released in February 2017 urge doctors to change their approach to back pain once again.
The Tricky One: Cancer As A Cause Of Low Back Pain And The Necessity Of Testing Just In Case When The Symptoms Justify It
Sorry I have to use the C word I know its kind of a bummer. But C happens.
A few cancers in their early stages can be hard to tell apart from ordinary back pain a bone cancer in the vertebrae, for instance and these create a frustrating diagnostic problem. They are too rare for doctors to inflict cancer testing on every low back pain patient just in case. And yet the possibility cannot be dismissed, either! This is an unsolveable problem.
Most cancers and ominous problems will inevitably start to cause other, distinctive, ominous symptoms, and it wont be long before someone catches on that theres more going on than just back pain. So it truly is an extraordinary circumstance for back pain to be ominous without causing other symptoms that raise the alarm.
For example, in 2017, the New England Journal of Medicine reported on a creepy case of slowly growing neurological deficit caused by a very stealthy cancer, which took a lot of diagnostic effort to solve.22shudder So sneaky cancers happen but they are crazy rare.
This is an unholy combination of factors: the exact same symptoms can have either an extremely rare but serious cause, or an extremely common but harmless cause that can be greatly aggravated by excessive alarm!
My favourite epitaph: I told you I was sick!
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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.
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.
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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.
Low Back Pain Symptoms And Signs
Pain in the lumbosacral area is the primary symptom of low back pain.
- The pain may radiate down the front, side, or back of your leg, or it may be confined to the low back.
- The pain may become worse with activity.
- Occasionally, the pain may be worse at night or with prolonged sitting such as on a long car trip.
- You may have numbness or weakness in the part of the leg that receives its nerve supply from a compressed nerve.
- This can cause an inability to plantar flex the foot. This means you would be unable to stand on your toes or bring your foot downward. This occurs when the first sacral nerve is compressed or injured.
- Another example would be the inability to raise your big toe upward. This results when the fifth lumbar nerve is compromised.
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Can Back Pain Be Prevented
Recurring back pain resulting from improper body mechanics may be prevented by avoiding movements that jolt or strain the back, maintaining correct posture, and lifting objects properly. Many work-related injuries are caused or aggravated by stressors such as heavy lifting, contact stress , vibration, repetitive motion, and awkward posture.Recommendations for keeping ones back healthy
Who Should I See For Lower Back Pain
Your primary care physician knows you best and should be your first contact for lower back pain. If he or she is unable to diagnose or treat the issue, you may get referred to a specialist, such as a rehabilitation physician . These specialists practice a comprehensive approach to lower back pain, and can diagnose and treat a variety of conditions that have lower back pain as a symptom.
Later, you may get referred to a physical therapist, a chiropractor or another practitioner depending on the nature of your back pain. The good news is that surgery is rarely needed for lower back pain. Only about one in ten patients needs lower back surgery, Chhatre says.
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Chronic Back Pain: Long
Chronic back pain, on the other hand, can be serious. Chronic pain is serious because the symptoms are strong enough to impact your health, mobility and quality of life for an extended period of time.
While chronic back pain can come on suddenly, it usually builds gradually and lasts more than six weeks. Chronic back pain can also be recurrent, meaning itll go away at times but regularly come back.
What causes chronic back pain? Chronic pain can be triggered by a new injury, but underlying conditions are usually the real cause. Muscle deconditioning is one of the most common contributors.
When To See A Spine Specialist For Chronic Back Pain
Sometimes back pain comes on quick, and you know exactly what caused it. After some stretching, resting and pain relievers, you’ll remember to bend with your knees next time.
But, other times, people experiencing back pain are often left thinking: I don’t even remember when the pain started or what I did to cause it. The reality is that the source of you back pain may not always be evident which can also make it hard to know when it’s time to see an expert.
Dr. Hwang says the following five signs likely indicate that it’s time to see a spine specialist for your back pain:
1. Your pain is severe. While some back pain is only mild to moderate, severe back pain is when your pain is constant, intense or gets worse when you’re resting or at night.
2. Your pain is persistent. If your back pain lasts longer than three months, it’s considered chronic and may require a tailored treatment plan.
3. Your pain isn’t isolated to your back. If your pain is traveling down your leg, you have numbness or weakness in your hips or legs, or you’re experiencing tingling in your legs and feet, it may be a sign that there’s pressure on your spine.
4. Everyday activities have become difficult. If your back pain is already affecting routine activities, don’t let it get so debilitating that it keeps you from doing things you enjoy.
Next Steps:
- Find a Houston Methodist spine specialist that can treat your back pain at a location convenient for you
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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.
All The Red Flags For Ominous Causes Of Back Pain
Red flags are signs or symptoms that something medically ominous may be going on. Red flags are not reliable, and their presence is not a diagnosis. When you have some red flags, it only indicates a need to look more closely. Sometimes red flags are missing even when there really is something serious going on and sometimes they are a false alarm.21 Check off all that apply hopefully none or few or only the least alarming of them!
Some of these red flags are much less red than others, especially depending on the circumstances. For instance, weight loss is common and often the sign of successful diet! Obviously, if you know of a harmless reason why you have a red flag symptom, it isnt really a red flag . But every single actual red flag in combination with severe low back pain thats been going on for several weeks is definitely a good reason to get yourself checked out.
Most people who check off an item or two will turn out not to have an ominous cause for their low back pain. But why not check?
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Concerned About Your Back Pain Symptoms We Can Help
Most back pain goes away on its own. But if your back pain has been lingering for more than two weeks without improvement, its been coming and going for some time, or if youre experiencing any alarming symptoms, dont delay the care you need. After all, its much easier to take care of yourself when you can move without pain.
Think PNBC may be right for you? Schedule a consultation.
What Can Cause Lower Back Pain
Most acute low back pain is mechanical in nature, meaning that there is a disruption in the way the components of the back fit together and move. Some examples of mechanical causes of low back pain include:
Congenital
- Skeletal irregularities such as scoliosis , lordosis , kyphosis , and other congenital anomalies of the spine.
- Spina bifida which involves the incomplete development of the spinal cord and/or its protective covering and can cause problems involving malformation of vertebrae and abnormal sensations and even paralysis.
Injuries
- Sprains , strains , and spasms
- Traumatic Injury such as from playing sports, car accidents, or a fall that can injure tendons, ligaments, or muscle causing the pain, as well as compress the spine and cause discs to rupture or herniate.
Degenerative problems
- Intervertebral disc degeneration which occurs when the usually rubbery discs wear down as a normal process of aging and lose their cushioning ability.
- Spondylosis the general degeneration of the spine associated with normal wear and tear that occurs in the joints, discs, and bones of the spine as people get older.
- Arthritis or other inflammatory disease in the spine, including osteoarthritis and rheumatoid arthritis as well as spondylitis, an inflammation of the vertebrae.
Nerve and spinal cord problems
Non-spine sources
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Symptoms Of Lower Back Pain
The symptoms of lower back pain can vary from person to person. It may come on suddenly, perhaps after youve lifted something heavy or moved in a way thats hurt your back. Or it may come on gradually over time or for no apparent reason. The pain can be mild or severe. Some people also have pain in the buttock or down one leg, sometimes as far as the calf or the toes. This is called sciatica.
Most people with back pain symptoms have whats called non-specific back pain. This means theres no clear or specific cause . It means that often tests cant really help because no specific damage to the spine or muscles around it would show up on them. This might sound unsettling, but it means that theres no serious cause for the pain.
Low Back Pain Exams And Tests
Medical history
- Because many different conditions may cause back pain, a thorough medical history will be performed as part of the examination. Some of the questions you are asked may not seem pertinent to you but are very important to your doctor in determining the source of your pain.
- Your doctor will first ask you many questions regarding the onset of the pain. He or she will want to know what makes the pain better or worse. The doctor will ask you questions referring to the red flag symptoms. He or she will ask if you have had the pain before. Your doctor will ask about recent illnesses and associated symptoms such as coughs, fevers, urinary difficulties, or stomach illnesses. In females, the doctor will want to know about vaginal bleeding, cramping, or discharge. Pain from the pelvis, in these cases, is frequently felt in the back.
Physical examination
Imaging
Nerve tests
- Electromyogram or EMG is a test that involves the placement of very small needles into the muscles. Electrical activity is monitored. Its use is usually reserved for more chronic pain and to predict the level of nerve root damage. The test is also able to help the doctor distinguish between nerve root disease and muscle disease.
Blood tests
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What Home Remedies For Lower Back Pain Actually Work
Unless youve had a major injury, such as a fall or car accident, you probably dont need to rush to the doctor for back pain. You may want to try these simple self-care strategies first.
Avoid bed rest. When lower back pain strikes, people often think complete rest will relieve back pain. However, a review of many clinical studies found that patients who retreated to bed actually experienced more pain and recovered more slowly than patients who stayed fairly active
Use ice and/or heat. Many people find that using ice or cold packs for periods of up to 20 minutes at a time helps reduce pain and swelling. Always wrap ice or a cold pack in a thin towel before putting it on your body so you dont injure your skin. You may also find that heat, such as a heating pad or warm bath, eases pain. Ice is recommended in the first 48 hours after injury then you can try a combo of ice and heat.
Try over-the-counter remedies. Short-term use of OTC pain relievers, such as the nonsteroidal anti-inflammatory drugs ibuprofen and naproxen, may ease your lower back pain. Also consider OTC creams, gels, patches, or sprays applied to the skin. They stimulate the nerves in the skin to provide feelings of warmth or cold in order to dull the sensation of pain.
