Up to 85% of working people can expect to experience low back pain during their lifetime. It is a very common problem amongst adults, often overlooked as a minor issue that one can live with. But every now and then, I see people who require immediate medical attention. So when is seeing a doctor the right choice?
The cause of back pain is not always apparent; in fact, in approximately 85% to 90% of individuals with back pain, no specific cause can be identified. Contributing factors include poor muscle tone, especially in the back and abdominal muscles; sedentary lifestyle; obesity; smoking; poor posture; and in particular, improper or heavy lifting. Some evidence suggests psychosocial factors like chronic stress and depression as determinants of back pain.
Back pain will usually go away with some over-the-counter pills and rest. But if the pain lasts for more than two weeks, and if it keeps you from performing daily activities, it's best you seek medical attention. Here are some red flags that should prompt you to see a doctor for your back pain:
1. Weakness, numbness or tingling in your arms and/or legs
If you have shooting pain down your arms or legs, or if your limbs feel weak or go numb repeatedly, it’s time to see your doctor for further evaluation. Make note of the area that tingles, and be sure to tell your doctor about it.
2. Low back pain at night
Low back pain particularly at night time can be a symptom of spinal tumours. It is also a symptom of spinal bone infection (osteomyelitis) and ankylosing spondylitis (AS), a condition that can cause the spine to fuse in a fixed, immobile position. Be sure to consult with your doctor if you have nocturnal low back pain.
3. Balancing problems or incontinence
In addition to back pain, if you have trouble controlling your bowels or bladder, or if you experience numbness and/or weakness in your hips causing you to fall or walk in an unsteady fashion, you should see your doctor.
4. Fever and weight loss
Tell your doctor if your back pain is accompanied by a fever or if you experience sudden, rapid weight loss without actively trying to lose weight. It could be a sign of an infection or even cancer.
5. Recent physical trauma
If you are an older adult, or an adult with osteoporosis, and have had a recent fall, accident or some kind of physical injury, you should see your doctor. A simple x-ray or an MRI can rule out a fracture of the spine.
I would strongly recommend you see your doctor if you have any of the following conditions and are experiencing back pain:
- previous history of cancer
- intravenous drug use
- prolonged intake of steroids
- immunosuppression (because of recent surgery or prescription drugs)
People understandably assume that the worst back pain is the scariest. In fact, pain intensity is a poor indicator of back pain ominousness, and some of the worst causes are actually the least painful. However, if the the pain is really bothering you and has persisted for over 6 weeks, I would suggest you play it safe, and consult with your doctor at your earliest convenience.
As always, feel free to connect with me or leave a comment.
Healthcare Consultant, in4MED
Hicks GS, Duddleston DN, Russell LD, Holman HE, Shepherd JM, Brown A. Low back pain. The American Journal of the Medical Sciences 2002; 324 (4): 207–211.
The author of this blog post is a Physician with over 10 years of experience working in the healthcare system as a clinician, researcher and educator. She is passionate about healthcare for older adults and strives to be a resourceful inspiration to caregivers.
*No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified healthcare professional.