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When to See a Doctor for Back Pain

Posted: June 1, 2007

You should see a doctor about your back pain if you have:
• Numbness or tingling
• Severe pain that does not improve with rest
• Pain after a fall or an injury
• Pain plus any of these problems:
◦ Trouble urinating
◦ Weakness
◦ Numbness in your legs
◦ Fever
◦ Weight loss when not on a diet

What is the difference between acute and chronic pain?
Acute pain starts quickly and lasts less than six weeks. It is the most common type of back pain. Acute pain may be caused by things like falling, being tackled in football or lifting something heavy.

Chronic pain lasts for more than three months and is much less common than acute pain.

Treatment for back pain depends on what kind of pain you have
Acute back pain usually gets better without any treatment, but you may want to take acetaminophen, aspirin, or ibuprofen to help ease the pain. Exercise and surgery are not usually used to treat acute back pain.

Following are some types of treatments for chronic back pain:

Hot or cold packs (or both)
Hot or cold packs can soothe sore, stiff backs. Heat reduces muscle spasms and pain. Cold helps reduce swelling and numbs deep pain. Using hot or cold packs may relieve pain, but this treatment does not fix the cause of chronic back pain.

Exercise
Proper exercise can help ease chronic pain but should not be used for acute back pain. Your doctor or physical therapist can tell you the best types of exercise to do.

Medications
The following are the main types of medications used for back pain:
• Analgesic medications are over-the-counter drugs such as acetaminophen and aspirin or prescription pain medications.
• Topical analgesics are creams, ointments and salves rubbed onto the skin over the site of pain.
• Nonsteroidal anti-inflammatory drugs (NSAIDs) are drugs that reduce both pain and swelling. NSAIDs include over-the-counter drugs such as ibuprofen, ketoprofen, and naproxen sodium. Your doctor may prescribe stronger NSAIDs.
• Muscle relaxants and some antidepressants have also been prescribed for chronic back pain, but it is not yet known if they work for back pain.

Behavior changes
You can learn to lift, push and pull with less stress on your back. Changing how you exercise, relax and sleep can help lessen back pain. Eating a healthy diet and not smoking also help.

Injections
Your doctor may suggest steroid or numbing shots to lessen your pain.

Surgery
Most people with chronic back pain do not need surgery. Surgery is usually used for chronic back pain if other treatments do not work. You may need surgery if you have:
• Herniated disc. When one or more of the discs that cushion the bones of the spine are damaged, the jelly-like center of the disc leaks, causing pain.
• Spinal stenosis. This condition causes the spinal canal to become narrow.
• Spondylolisthesis. This occurs when one or more bones of the spine slip out of place.
• Vertebral fractures. A fracture can be caused by a blow to the spine or by crumbling of the bone due to osteoporosis.
• Degenerative disc disease. As people age, some have discs that break down and cause severe pain.

Rarely, when back pain is caused by a tumor, an infection, or a nerve root problem called cauda equina syndrome, surgery is needed right away to ease the pain and prevent more problems.


Source: National Institute of Arthritis and Musculoskeletal and Skin Diseases

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