Back pain: when should you see a doctor?
Written by:Many people experience back pain at least once in their lives. Although in most cases it may disappear after a few weeks or months, occasionally when the pain persists or keeps on returning it is advised to seek advice from a GP or specialist.
Consultant orthopaedic spinal surgeon Mr Khalid Salem provides the answers to your frequently asked questions about such pain, including the causes and pain relief.
What are the most common causes of back pain?
Sometimes it is difficult to define the root cause of back pain, in which case the condition is termed “non-specific” back pain. Occasionally after an injury such as a strain, an individual may experience pain in their back, but rarely is the cause serious.
Every now and then a medical condition can cause back pain and is usually correctable. The key is identifying a “specific” cause for the back pain. Conditions such as a slipped disc, spinal stenosis, and various causes of spinal malalignment can be the reason an individual’s back hurts.
In very rare circumstances, back pain might be the result of a broken bone in the spine because of osteoporosis, an infection, or even cancer. If protracted and intrusive, the key in making a diagnosis is based on the detailed analysis of the symptoms and signs paired with targeted investigations which might vary depending on the working diagnosis.
How to relieve back pain
There are measures that can be taken to hasten an individual's recovery period and alleviate pain. Doctors advise remaining as active as the pain permits, as well as continuing with daily life as normal. Too much rest increases the chance of making the back pain worse.
Certain exercises and stretches may help to alleviate symptoms. These include swimming, walking, and yoga. Anti-inflammatory painkillers may be recommended, only if the medicine is deemed safe for the individual in question. A pharmacist should be able to answer any questions regarding this.
For short-term pain alleviation, using hot or cold compression packs can help a great deal. A hot water bottle or a bag of frozen vegetables work to equal effect but be careful as excessive application of such methods can cause skin changes which on occasion might be permanent.
When to seek medical advice
If the pain doesn't show signs of improvement within a few weeks, is getting worse, or hinders you from taking part in daily activities, you should seek advice about your back pain from a GP, physiotherapist, or specialist. They will be able to recommend possible treatments after an examination.
As a general rule, spinal interventions are planned in a step ladder fashion; starting with the simplest and least invasive and escalating the treatment based on need accordingly.
Although the natural history of back pain is to subsides over time with the great majority settling within 3 months, there are a number of features that should prompt an earlier medical review and these include: unexplained weight loss, numbness or tingling in the genitals or buttocks, difficulty peeing, or the appearance of a swelling or deformity on the back.
After a period of waiting, physiotherapy and pain medication and if they have been proven less effective, options such as targeted injections can be considered and these vary depending on the investigation’s findings (they can target the joints, the nerves and in certain conditions even defects in bone). Injections tend to have a combined diagnostic and therapeutic value and in certain cases will be the stepping stone to plan the next step in management.
In cases where the diagnosis is very clear and after a careful discussion with the surgeon, patients might choose to proceed with a more “definitive” treatment after considering the risks and benefit balance. The treatment is always tailored to patients needs and carried out on the basis of a joint decision where the well-informed patient is an equal partner in the decision making process.
How to prevent back pain
Like so many conditions, often prevention is better than cure. Although preventing back pain is no easy, as so much depends on the cause, there are a number of ways to decrease the risk of developing back pain. These include:
- Staying active through regular back exercises and stretches.
- Maintain a good posture when sitting and avoid slouching.
- Be careful when lifting heavy objects (lift with the legs, not the back) – the lift and twist movement seems to affect the back the most and increase the vulnerability of the spinal motion segments .
- Maintain a healthy weight. A lot of the common causes of back pain will resolve just through weight loss. Additionally, treatments are more predictably successful when the wight is better managed.
If you are suffering from back pain and would like to book a consultation with Mr Salem, simplyvisit his Top Doctors profile today.
