When Does Your Back Pain Require Medical Attention

If you consider that more than 80% of adults in the United States will have some experience with lower back pain, you realize the extent of the problem. Back pain can range from overdoing it at the golf course to chronic arthritis that affects your ability to function normally, and everything in between. Whatever the circumstances of your back pain, there are times when seeking our help can help you get the much-needed relief youve been looking for.

At Comprehensive Pain Management, our team of interventional pain management specialists, led by Drs. Do Chan and Boris Shwartzman, understands the effects that back pain can have on your life, which is why we offer a broad range of traditional and cutting-edge treatment options.

If you’re experiencing back pain, heres a look at the problem and how we can help.

How To Know If Your Back Pain Is An Emergency

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.

What are the symptoms of lower back pain?

The symptoms youll likely notice include numbness located at the bottom of the pelvis and around the area of your seat. Bladder or bowel problems, especially recent onset of urinary retention , increased frequency of urination and/or overflow incontinence.

Can a back infection cause severe back pain?

The resulting spinal infection, called vertebral osteomyelitis, can result in back pain. The symptoms of a spinal infection are variable and depend on the age of the patient, the severity of the infection, and the location in the spine. In addition to back pain, spinal infection symptoms may include some combination of the following:

Arthritis Of The Spine

Arthritis of the spine the slow degeneration of the spinal joints is the most frequent cause of lower back pain. All of us experience wear and tear as we age, and it is normal for your lower back to start acting up as you get older. As the cartilage breaks down between the spinal joints, surrounding tissues may become inflamed. The inflammation and the thinning of cartilage increase friction in the joints, which may cause pain in the lower back.

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Why Is Lower Back Pain Such A Common Problem

The bottom part of your back typically has just five vertebrae fewer than your neck and mid-back. And these vertebrae do a lot of heavy lifting! Your lower back is where your spine connects to your pelvis, bearing the weight of your upper body. This area experiences a lot of movement and stress, which may lead to wear, tear and injuries.

Which Lifestyle Factors Contribute To Lower Back Pain

There are three major lifestyle factors that may affect your chances of developing lower back pain:

• Multiple studies have established a link between smoking and lower back pain. Smoking raises inflammation inside the body and hinders the body from healing itself.
• Obesity is also associated with several types of chronic pain, including lower back pain. In people with high body mass index , the stress on the spine increases, contributing to even more wear and tear.
• Your level of physical activity can also play a role in your lower back health. While a sedentary lifestyle could increase your risk of developing lower back pain, so can excessive or strenuous physical activity. Check with your doctor if you are unsure about your ideal level of physical activity.

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Identifying Subgroups Of Patients More Amenable To Specific Treatments

A recently published randomised clinical trial found that patients with acute or subacute low back pain had significantly better functional outcomes when they received a matched treatment compared with an unmatched treatment.23 The authors examined all patients before treatment and assigned them to one of three groups thought most likely to benefit the patients. Patients were subsequently randomised irrespective of this subgroup assignment towards one of the three interventions groups with the same treatments. The analyses were focused on matched versus unmatched treatment according to their baseline subgroup assignment.

Useful websites

Clinical Evidence

Up to date evidence for clinicians regarding benefits and harms of treatments for a variety of disorders including low back pain

Cochrane Back Review Group The activities of the review group responsible for writing systematic Cochrane reviews on the efficacy of treatments for low back pain

Cochrane Collaboration The organisation responsible for writing systematic reviews and meta-analyses on the efficacy of treatments which are published in the Cochrane Library

European Guidelines The recently issued European guidelines on the prevention and treatment of low back pain

Ongoing research

A patient’s perspective

Mrs Mooren-Baars, aged 76 years, Breille

Know When To Seek Medical Care For Lower Back Pain

Back pain doesnt necessarily require medical attention in all cases. Mild pain that doesnt overly impair your movement or daily activities often goes away on its own. A bit of soreness should be relatively easy to treat with over-the-counter remedies. However, there are many instances when its a good idea to speak with your doctor.

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If You Are Unable To Bend Sit Or Lay Flat

The inability to move your torso or have it in a stationary position without pain might also indicate a larger issue. Any loss of mobility that you had before the pain might point to nerve damage or impairment. This might also be a sign that there is an injury to the vertebrae in your spine. Without the ability to perform these movements, additional problems might occur such as loss of sleep, missing days at work, and lets not forget, your sanity.

When To Seek Medical Care For Low Back Pain

If lower back pain does not start to subside within one to two weeks, or if there are troubling symptoms, medical care should be sought. A health professional will first identify a general source of pain and then determine appropriate and effective methods of pain management.

Certain symptoms may indicate a medical emergency. While these conditions are rare, it is important to seek immediate medical attention should the any of the following symptoms accompany back pain:

• severe abdominal pain

Additionally, if back pain begins after an injury immediate medical care is warranted to check for damage to the spine.

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Why Seek Help For Your Lower Back Pain

Whether your lower back pain is acute or chronic, your primary goal is to restore pain-free movement and thats our goal, as well.

Through our chiropractic treatment, we correct any misalignments along your spine to encourage a better flow of valuable resources that can speed up your recovery. Your body is incredibly self–sufficient and contains the resources it needs to rebuild and repair your soft and hard tissues on a cellular level. But if these resources are blocked along the primary highway in your body your spine the healing process can be considerably slowed down.

Ultimately, the treatments you receive at our practice are designed to help relieve the pain and restore mobility, which is why we recommend that you come see us at the first signs of lower back pain. This immediate attention can help save you from much larger problems down the road.

If your lower back is in pain, please contact our office in Indianapolis, Indiana, to get on the road to relief.

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If Your Back Pain Is Causing Depression

There is a close correlation between depression and chronic pain. And why wouldnt there be? Living with such pain day in and day out, leaving you unable to connect with the ones you love, complete work, or enjoy recreational activities that once brought you joy would make miserable. It can feel as though it consumes your life. Finding out what you can do to relieve the pain, and support your mental health, to get back to your life is your best bet for success.

There are many of us who try to play the tough card and think Oh, it will clear up on its own. But remember it doesnt hurt to know the cause of any pain, back or otherwise, especially if its accompanied by other symptoms, was a result from major trauma, or lasts longer than a couple weeks.

Not only will you know whats causing your pain, but youll be able to take a proactive and positive approach to relieving yourself of that pain and regaining your life. As the cliché goes, Its better to be safe than sorry.

Now you know that there are many factors that go into determining what the issue is and if you need professional help. First, take the time to really evaluate your body. Notice if there is anything more than back pain going on. Then ask! When you come to see us, ask if the symptoms are or could be related.

To your pain free life,

Team Satori

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Why Back Pain Can Mean So Many Things

You may find yourself asking how there can be such a wide range in pain levels, locations and associated symptoms. Let us explain. The back is a very large area made up of many different parts that connect or contribute to your bodys function as a whole. For example, the back includes:

The Spine 7 Cervical Vertebrae consists of the neck 12 Thoracic Vertebrae consists of the thorax 5 Lumbar Vertebrae consists of the lower back above the pelvis

Spinal Nerves

Intertransversarii muscle supports movement between the individual vertebrae The multifidus spinae supports movement of the spine as a whole.

As you can see, there are many places or parts that can be injured or out of place. All these pieces are vital for your normal functioning and none should be discounted. Just like your dishwasher, when one small part goes awry, the entire system seems to stop working.

Considering back pain can be so complex, what do you actually need to look out for?

What Do Guidelines Recommend

In many Western countries, clinical guidelines have been issued for the management of low back pain. In general, recommendations are similar across guidelines. Box 2 summarises the main recommendations for diagnosis and treatment for acute low back pain from 11 countries.21 For chronic low back pain, far fewer guidelines are available. Box 3 shows the recommendations from the recently issued European clinical guidelines for chronic low back pain.22 It must be noted, however, that these recommendations are made by a single guideline committee.

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When Surgery Is Necessary

When conservative treatment for low back pain does not provide relief or neurologic symptoms are worsening or severe, surgery may be needed. Candidates for surgery present any of the following:

• Reasonably good health
• Back and leg pain limits normal activity or impairs quality of life
• Progressive neurologic deficits develop, such as leg weakness, numbness or both
• Loss of normal bowel and bladder functions
• Difficulty standing or walking
• Medication and physical therapy are ineffective

If surgery is recommended, neurosurgeons have a variety of options available to help relieve pressure on the nerve roots. If several nerve roots and discs are causing the pain or if degeneration and instability exist in the spinal column, the neurosurgeon may choose: a minimally invasive approach a more open decompression or fusing the vertebrae together with bone grafts and stabilizing them with instrumentation, including metal plates, screws, rods and cages, depending on the extent of disease. After such surgery, patients may gain restored mobility in the back, including the ability to bend over. In addition, patients may require postoperative physical therapy.

The benefits of surgery should always be weighed carefully against the risks. Although a large percentage of patients with low back pain report significant pain relief after surgery, it is not guaranteed that surgery will help.

Can Lower Back Pain Be Related To Weather

If you feel like your lower back pain worsens on days when its cold or the weather is changing, you are not imagining things. Back pain can indeed be related to barometric pressure and outdoor temperature. Changes in pressure can sometimes cause pain in arthritic joints, including the spine. Muscles and joints in general react to the environment, which can make them stiffer and more likely to suffer an injury.

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When To Seek Medical Attention When You Have Back Pain

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Back pain is something that you should never be avoiding. It is not known to a huge number of people that even back pain may turn very serious if not detected or treated on time in a proper manner. Another mentionable factor is, there are certain kinds of back pain that keeps getting worse with time and this is the reason why back pain must be treated at the beginning stage.

When to seek medical attention?

Back pain does not really have a singular cause, in other words, there are multiple factors that can be the reason for back pain. From muscle strain and broken bone to arthritis, several factors may cause back pain. To be mentioned once again, never ever make a regrettable decision of ignoring the symptoms of back pain because once it turns serious, it can make you face so many physical complexions, which may even turn hard to treat. The point is, it is necessary to know when to consult a genuine and reliable medical expert once any of these above-mentioned symptoms start to get visible in you. It is always necessary to get in touch with a certified doctor on time because it can help you get your disease detected at the initial stage.

How the diseases are detected

What Is The Role Of Invasive Procedures In Chronic Low Back Pain

A recently published review summarised the available evidence about the efficacy of surgery and other invasive interventions for low back pain and sciatica.15 A number of interventions, including facet joint, epidural, trigger point, and sclerosant injections, have not clearly been shown to be effective. No sound evidence is available for the efficacy of spinal stenosis surgery. Surgical discectomy may be considered for selected patients with sciatica due to lumbar disc prolapse that do not respond to initial conservative management. The role of fusion surgery for chronic low back pain is under debate.16 Recent randomised clinical trials comparing fusion surgery with conservative treatment showed conflicting results.17–19 Recommendations that fusion surgery should be applied in carefully selected patients are difficult to follow because no clear and validated criteria exist to identify these patients in advance.

Box 3: Recommendations in the European clinical guidelines for diagnosis and treatment of chronic low back pain22

Diagnosis

Treatment

RecommendedCognitive behaviour therapy, supervised exercise therapy, brief educational interventions, and multidisciplinary treatment, short term use of non-steroidal anti-inflammatory drugs and weak opioids.

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When You Should Go To The Er For Back Pain

If your back pain is accompanied by any of the following symptoms, head to your closest emergency room because you could be dealing with a more serious condition or injury:

• Sudden spike in pain, discomfort, weakness or numbness
• Loss of bladder function
• Unexplainable weight loss
• The pain results from a fall or severe blow to your back

If you experience any of these symptoms, its a good idea to talk to your doctor so you can determine next steps for managing pain.

What Will My Doctor Do

Back pain is a common problem for many people and can be caused by a variety of different factors. While it may seem like something that will go away on its own, the longer you put off treatment, the more likely your condition could become chronic. Its important to remember that there are many options available for treating back pain and most cases can be resolved with proper care.

We begin our evaluation with a thorough history taking and physical examination, which includes checking for tenderness, spine range of motion, strength, sensation, reflexes, and provocative tests designed to find out what triggers your pain. Depending on the results from these tests we may order imaging studies such as X-rays or MRIs.

These imaging studies will help your doctor to see how much damage has been done already or whether any degenerative changes exist in other areas of the spine besides where youre experiencing symptoms now. In some cases electromyography testing may be ordered along with nerve conduction velocity testing , both used together can help us identify muscle problems causing your lower back pain.

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Your Pain Extends To Other Body Parts

If you’re experiencing severe back pain that is coupled with pain in other areas such as shooting pain down your leg then you should see a doctor. This could be a sign that you have sciatica, a form of pain that affects the sciatic nerve, which runs from the lower back and through the buttocks before branching down each leg. This condition usually results from a herniated disk. A doctor will be able to offer a variety of ways that you can relieve this pain.

The Common Causes Of Lower Back Pain

Theres no shortage of circumstances that can bring on lower back pain, but a few rise above the rest in terms of prevalence. The most common causes of lower back pain include:

Though some of these issues may be temporary, such as sciatica, many pose a real threat for ongoing problems with your lower back, which is why medical intervention is paramount in most all cases.

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