Latest update February 24th, 2025 9:02 AM
Low Back Pain: Understanding the basics is the key to improvement
By Dr Zulfikar Bux
Assistant Professor of Emergency Medicine
Almost everyone gets back pain at some point. Low back pain can be scary but it is almost
never serious and would usually go away on its own. The cases that require surgery or urgent care are rare. When lower back pain becomes serious then one can be left with unbearable pains or debilitating symptoms.
When should you visit your doctor with low back pain?
* Recently had a fall or an injury to your back
* Have numbness or weakness in your legs
* Have problems with bowel or bladder control
* Have unexplained weight loss
* Have a fever or feel sick in other ways
* Take steroid medicine, such as prednisolone, on a regular basis
* Have diabetes or a medical problem that weakens your immune system
* Have a history of cancer or osteoporosis
* Your back pain is so severe that you cannot perform simple tasks
* Your back pain does not start to improve within 3 to 4 weeks
What causes low back pain?
In some cases, doctors may not know what causes your low back pain. Pain can happen if you strain a muscle or hurt a tendon or ligament. But if that is the cause of your pain, doctors have no way of knowing it for sure. Pain can also happen if you have:
* Damaged, bulging, or torn discs
* Arthritis affecting the joints of the spine
* Bony growths on the vertebrae that crowd nearby nerves
* A vertebra out of place
* Narrowing in the spinal canal
* A tumor or infection (but this is very rare)
Should I get an imaging test, like an MRI?
Most people do not need an imaging test. Most cases of back pain go away within 4 to 6 weeks — or in even less time. Doctors usually do not order imaging tests before then unless there are signs of something unusual.
If your doctor does not order an imaging test, do not worry. He or she can still learn a lot about your pain just from looking you over and talking with you. Plus, treatment can start right away, even without an imaging test.
What can I do to feel better?
The best thing you can do is to stay as active as possible — even if you are in pain. People with low back pain recover faster if they stay active. Walk as much as you can. If you stopped working because of your pain, try to get back to your normal routine soon. But do not overdo it.
When you start to feel better, ask your doctor about exercises that can help strengthen your back. These exercises can help you get better faster and might make it less likely that you will have pain again.
How is back pain treated?
A small number of people end up needing surgery to treat back pain. But most people do well with simpler treatments, such as:
* Medicines – First, you can try pain medicines that you can get without a prescription. If these do not work, doctors can prescribe stronger pain medicines. Sometimes, doctors suggest a medicine to relax the muscles (called a “muscle relaxant”).
* Physical therapy to teach you special exercises and stretches
* Spinal manipulation, which is when someone like a physical therapist or a chiropractor moves or “adjusts” the joints of your back
* Acupuncture, which is when someone who knows traditional Chinese medicine inserts tiny needles into your body to block pain signals
* Massage
* Injections of medicines that numb the back or reduce swelling
What can I do to keep from getting back pain again?
Stay active and learn exercises that help strengthen and stretch your back. Swimming is one of the best exercises to strengthen muscles and ligaments of the back. Learn to lift using your legs instead of your back. And avoid sitting or standing in the same position for too long. Medicine has advanced and one should not have to suffer long periods with back pain. Your doctor may opt to treat you in a step by step fashion until a proper remedy is found for your back pain. Patience, adherence to treatment and preventive exercises are your best bet when it comes to relieving your back pain in the long run.
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