Nearly everyone will experience back pain in their lives. For most of us, back pain isn’t a matter of “if” but “when.”
Fortunately, most of the time when you have back pain, it isn’t usually a great cause for concern. The pain usually goes away on its own with a little time and self-care. On the other hand, you may need to see a doctor or even go to the emergency room for more serious back pain.
As a physical medicine and rehabilitation physician who also specializes in pain management, I work closely with spine surgeons, physical therapists and other back specialists to help people get the right care for their back pain. So how do you know when you need to see a spine specialist? And what can be done to help you feel better if you have back pain? The answers to those questions can depend, in part, on how often you have back pain and how much it affects your life.
Not all back pain is the same
The first step in treating back pain is to identify what kind you have. In general, there are two types of back pain:
Acute back pain. This type of back pain comes on suddenly and is relatively brief. It can last for a few days to up to six weeks. Acute back pain is commonly caused by injuries. For example, you can get a backache if you overstretch or hurt your back muscles while exercising, or if you lift something heavy the wrong way. Even sitting at a desk all day can hurt your back if your posture is poor.
Chronic back pain. This type of back pain lasts three months or longer. Chronic back pain can also come and go, but it still may have a big impact on the quality of your life and your ability to engage in certain activities. Chronic back pain symptoms are similar to those of acute back pain, though they often come on gradually and usually aren’t linked to a specific activity, like strenuous exercise. Everything from poor posture to herniated spinal discs to spinal stenosis can cause chronic back pain.
What you can do about back pain
Acute back pain — the kind that might start after you’ve twisted your back, for instance — typically gets better after a few days to a few weeks.
You can try to ease your pain by:
- Taking over-the-counter pain relievers.
- Applying ice or a heat pad to your back.
- Staying as active as you comfortably can. This doesn’t mean you should exercise vigorously, but it’s best to avoid bed rest, which can actually make the pain worse. You might take short walks or try gentle stretches.
When to see a doctor for back pain
You should make an appointment to see a doctor if your back pain hasn’t started to improve after two weeks. And I recommend that you seek medical help as soon as possible if:
You have back pain and leg pain. If you have shooting pain that extends from your back through your buttocks and down one of your legs, that could be signal sciatica, a pinched-nerve condition that typically is caused by a herniated disc.
You have back pain plus incontinence. Back pain that goes hand in hand with loss of control over your bladder or bowels is typically considered a medical emergency. It can be a sign of severe nerve damage that can become permanent if left untreated. Immediate surgery may be needed to take pressure off the spinal cord.
You have weakness in your legs. This can occur if a nerve is pinched as a result of disc damage or a narrowing of the spine.
You have a high fever along with your back pain. This is a potential sign of an infection that may need to be treated immediately.
Your back pain started after an injury. For example, after a fall, a blow to your back, or a car crash. Your pain could be the result of a spinal fracture.
Your back pain suddenly gets a lot worse. This can be a sign of a more serious back problem or a medical issue other than a spine condition.
You’ve lost weight without trying. Back pain that goes along with unexplained weight loss may have more serious causes, including possibly a tumor.
Pay attention to your spine health
As I often tell people, you know your body better than anyone else. If your back pain symptoms aren’t getting better — or if they’re getting worse — it’s probably time to see a specialist. Some back pain problems can get worse if you put off seeking care.
The right treatment may depend on the cause of your back pain. To find out what’s causing my patients’ back pain, I take their medical history and do a physical exam. I may request that the patient undergoes neurological and other imaging tests, too.
Feeling better doesn’t always mean having surgery
At Temple, we know that back pain shouldn’t keep you from enjoying your life. We also know that most people do not need surgery to relieve their symptoms.
One possible solution for chronic back pain is physical therapy. During physical therapy, you will learn exercises to strengthen your back and abdominal muscles that support your spine. Having a stronger back and core may help relieve the pain.
Your therapist also may help you learn proper lifting and posture techniques. Together with conditioning, these techniques may help you avoid more back problems in the future. In fact, I’ve heard stories from patients about just how surprised they were that physical therapy greatly reduced the amount of pain they were in.
Medications can also help to make back pain more manageable.
I typically recommend trying therapies like these for several weeks. If that doesn’t help enough, we can try more aggressive treatment options, such as spinal injections. The shots can reduce inflammation in the spine, offering temporary relief of back pain and sciatica.
When might I need surgery?
I tell my patients that you should usually try conservative treatments for at least six months before we talk about surgery. If you have chronic back pain and nonsurgical treatments don’t help enough, you may need spine surgery. To treat all disorders of the spine, Temple spine surgeons use innovative and minimally invasive techniques that are available today.
Find out what’s causing your back pain
A back pain specialist at Temple Health can get to the bottom of your ongoing back pain and help you find relief.
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