Lower Back Pain: When to See Your Doctor

Have you experienced pain in the lower portion of your spine? You are not alone. About 80 percent of adult Americans will have lower back pain at some point in their lifetime.

It is a common medical complaint that is responsible for many job-related disabilities as well as missed workdays. Although most cases of lower back pain will improve on their own, it is important to see your physician if the condition lasts more than four weeks.

Lower back pain can be the result of an injury to a muscle or ligament. Men and women are equally affected and the pain can extend from a slight constant discomfort to a very strong ache that can leave the person disabled. Acute back pain is defined as lasting up to four weeks, “subacute” back pain ranges from four to 12 weeks. When lower back pain lasts longer than 12 weeks it is considered chronic back pain.

(Video: The Baptist Health South Florida News Team hears from Juliet Vento, M.D., an internal medicine physician with Baptist Health Primary Care., about lower back pain and when to seek medical help. Video by George Carvalho and Alcyene Almeida Rodrigues.)

Common Causes
The most common causes for lower back pain include a car accident, a fall, improper lifting, poor posture, sports injury, lack of exercise, pregnancy, fracture, arthritis, age, and even stress.

According to the American National Institute of Neurological Disorders and Stroke (NIH), about 90 percent of all lower back pain cases won’t need a surgical procedure. However, pain recurrence is as high as 50 percent in all patients within one year following an injury or initial bout of pain.

Even though most lower back pain is acute, about 20 percent of people affected will develop chronic pain, the NIH says. That is why it is important to seek medical attention “if your back pain has been lasting more than four weeks or if you are having others symptoms like weakness in the legs or any kind of numbness or tingling down the legs,” says Juliet Vento, M.D., an internal medicine physician with Baptist Health Primary Care.

Treatment Options
The most conventional non-surgical treatments include hot or cold packs, strengthening exercises, physical therapy, anti-inflammatories, such as Ibuprofen and Naproxen, and low dose courses of steroids.

Epidural steroid injections have been a common back pain treatment option since 1952. However, a new study published last month by the American College of Physicians (ACP) found that these injections are not efficient in fighting chronic lower back pain.  Researchers evaluated 135 patients with degenerative disc disease and noticed that the injections had only provided short-term pain relief for the patients who were suffering from the condition for over 12 weeks.

Earlier this year, the ACP also published new clinical guidelines on non-invasive treatment for lower back pain which recommends that physicians first use non-drug treatments, such as heat applications, massage, yoga or supervised physical therapy, before experimenting with drug therapies for acute, subacute and chronic back pain. The ACP discourages the use of prescription opioid pain medications due to the risk of addiction or overdose.

How to Keep Your Back Healthy (NIH) 

• Stretch before physical activity.
• Balance your weight on your feet.
• Keep work surfaces at a comfortable heights.
• Good posture when sitting.
• Wear comfortable shoes.
• Sleep on a firm surface.
• Don’t lift too heavy objects. Lift from the knees and keep objects close to the body.
• Prevent weight gain and eat a diet rich in calcium, phosphorus and vitamin D.
• Quit smoking.

Tags: back pain, back surgery, Baptist Health Neuroscience Center, Miami Orthopedics and Sports Medicine