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Back Pain – When to See a Doctor

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Back Pain – When to See a Doctor

Many of us are worried about back pain – the reason, it is one of the common causes of visiting a doctor.

Back pain has become so common nowadays that people of all ages are becoming prone to it – irrespective of the causes. In general, back pain is not a local or regional issue – it is a leading cause of people missing work worldwide – owing to its severity. Majority of the people suffer from back pain at least once, if not more often, even if they lead a very active and healthy life.

Though there are many causes of your back pain, it is possible to manage it, prevent it or get relief from the recurrent episodes of back pain provided you should pay attention. Let us try to understand the types of back pain, the signs and symptoms, causes, risk factors – and also when you should visit your doctor for your back pain.

Signs and symptoms of back pain

  • Stabbing pain
  • Shooting pain
  • Lower back pain
  • Pain that increases with walking, standing and bending
  • Pain that worsens with lifting objects and carrying load
  • Pain that increases with activity
  • Dull pain which is progressive
  • Pain that worsens with bending
  • Pain that improves with reclining
  • Pain that comes in episodes

Back Pain – Types

Acute back pain: This type of back pain manifests suddenly and may last for up to five to six weeks. It can be due to some jerk, fall or lifting something heavy.

Chronic back pain: This type of back pain may last for more than two to three months, but it is less common though.

Common Causes of Back Pain

Bones, muscles, disks, tendons, ligaments together form the complex structure of human back – which helps in supporting the body and movement. The spine consists of segments of bones called vertebrae – which are cushioned with cartilaginous pads called disks. Any issues associated with any of these components of the back can lead to back pain. The problems of the back can be due to muscle strain, muscle overuse, poor posture, injury, recurrent strain, medical conditions, and others. Sometimes, the causes can be unknown.

Your activity levels, healthy food habits and good physical health play an important role in keeping your back healthy.

Muscle Strain

You need to be very careful about your body movements as a sudden jerk or awkward movement can cause debilitating back pain – wherein the spinal ligaments and muscles strain.

Poor Physical health

Those who are in bad health – especially in poor physical condition are prone to back issues when they constantly strain their back with poor posture, activity or lifting.

Muscle spasm

Painful back muscle spasms are often due to sore muscle owing to excessive physical activity, vitamin D deficiency, electrolyte imbalance, dehydration and heat shock.

Ruptured or Bulging Disc

Ruptured disc due to osteoporosis can cause back pain. Spinal cord vertebrae are cushioned by discs – they act just like shock absorbers and take on the jerks, but when the discs rupture or bulge out they press nerve which may lead to back pain.

Osteoporosis

Osteoporosis is a condition in which your bones become porous, brittle and prone to fractures. Vertebrae are prone to fractures due to osteoporosis. Compression fractures are more common in vertebrae.

Due to osteoporosis, the vertebrae of the spine and the disks that cushion those vertebrae rupture and put pressure on nerves causing back pain.

Sciatica

Herniated disc or bulging disc presses a nerve which may result in pain that radiates down the back of the leg after travelling through the buttock. The sharp and shooting pain is called as Sciatica.

Abnormal curvature of the spine (skeletal irregularities): Scoliosis is a condition associated with the abnormal curvature of the spine mostly to the side. This is common after age 50. Back pain is associated with scoliosis.

Kidney problems

Kidney stones or kidney infection can cause back pain.

Spinal stenosis

It is a condition wherein the space around the spinal cord narrows leading to lower back pain. Osteoarthritis or arthritis can lead to this condition.

When to See a Doctor for Your Back Pain?

If you have back pain with tingling sensation and numbness in your legs or feet, you should visit a doctor. When you experience pain, which has increased significantly after an accident, fall, fall from a height, motorcycle accident or any other type of injury to the back, you should visit a doctor for better examination, evaluation and diagnosis.

If you are above 50 years of age and have had mild trauma recently – slipped and fell down a few steps and landed on buttocks – and since then developed back pain. It is better to consult a doctor.

If you have arthritis and a history of osteoporosis with bone fractures owing to which you could develop back pain. In such cases, it is better to see a doctor.

Individuals who are on prolonged steroids use due to rheumatoid arthritis, joint pains, COPD or asthma are at risk if they develop back pain. Similarly, individuals with a previous history of cancer can be at risk if they experience severe back pain.

If your back pain is associated with a fever above 100 F, it is better to visit a doctor. Individuals who develop low back pain that gets worse with rest should see their doctor as this could be due to malignancies, infections or ankylosing spondylitis.

If you have a back pain which is associated with walking difficulty, inability to raise legs, foot, move your ankle, raise or lower your foot at ankle; inability to raise your toe and walk on your heels, then this could be due to nerve compression or injury. Therefore, you should consult a neurologist to know the cause of your back pain.

Dr Vikram Sharma

MBBS, MD, DN (London), FAAN (USA)

Senior Consultant Neurologist

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