Is Your Back Pain Muscle Strain or Spine-Related? When To See a Doctor

Sudden, intense back pain can leave an otherwise healthy adult unable to perform even the simplest movements — like dressing or getting up from a chair. While this can be frightening, try to relax. It’s probably a pulled or strained muscle that will heal itself in a few days.

But in a small percentage of cases, back pain is caused by underlying spinal conditions that may require treatment.

When To See a Doctor Immediately for Back Pain

If your back pain follows an injury or fall, develops suddenly without an obvious cause, is severe and unrelenting for more than 48 hours or includes any of these symptoms, you need to see a healthcare professional at once:

• Fever
• Numbness or tingling in your legs or arms
• Weakness in one or both legs or arms
• Bladder or bowel issues
• Worsening balance and coordination

What Causes Uncomplicated Back Pain?

A muscle or ligament can be injured if it is stretched too far or torn, typically by a sudden movement, lifting a heavy object or overuse. You may feel pain, soreness, stiffness, muscle spasm and have difficulty moving.

These injuries are diagnosed as “uncomplicated” back pain and generally heal on their own. You can use over-the-counter pain relievers to reduce swelling and discomfort, and alternate between ice and heat on the injured muscle to ease tightness. It’s also important to keep moving to whatever extent possible as extended bed rest prolongs healing.

The back is a complex structure of bones, muscles, nerves, ligaments and connective tissue that together allow the body to move while protecting the spinal cord, a bundle of nerve tissue that serves as your body’s communication highway, delivering electric signals from the brain to the rest of the body.

The muscle groups in your back are some of the biggest and strongest in your body, allowing you to stand, twist and move your torso. They are also prone to injury, especially if you have any of these risk factors:

• Weak abdominal muscles
• A sedentary lifestyle
• Poor posture
• Excess weight or obesity

What Is Neuropathic Back Pain

In about 5% of all cases of back pain, the nerve endings in the spine and lower limbs are involved. This neuropathic pain can be due to injury or any of these age-related changes in the spine:

• Osteoporosis. The bones of the spine (vertebrae) weaken and lose mass, raising the risk of compression fractures.
• Bone spurs. These bony growths develop due to long-term wear and tear. Pain occurs If a bone spur presses on nearby nerves and irritates surrounding tissues.
• Herniated discs. The spinal discs, soft cushion-like structures spaced between the vertebrae, lose water and shrink. The pain of a “ruptured” or herniated disc occurs when the gel-like interior pushes out through a tear and the leaked material presses on nearby spinal nerves. (This can also occur in younger patients without significant degeneration.)
• Facet joint arthritis. The facet joints that connect vertebrae develop arthritis, leading to inflammation, pain and stiffness.

Your doctor will determine which disorders are causing your pain.

How Is Back Pain Diagnosed and Treated?

Your exam will begin with a detailed history of your pain, including location, duration and intensity, followed by a physical exam. In most cases, your healthcare provider will begin with a conservative treatment approach, which could include pain management, a muscle relaxant or anti-inflammatory medication and physical therapy. That’s often enough to manage the symptoms of herniated discs and relieve the pain of facet arthritis, bone spurs and compression fractures.

Your physician might recommend over-the-counter pain relief medicine or prescribe something stronger. Pain also may be managed with an injection of a steroid into the epidural space, the area inside the spinal canal surrounding the spinal nerves.

If these conservative treatments don’t work after six to 12 weeks or if significant neurological deficits develop, your healthcare provider may discuss surgical options with you, which include:

• Discectomy and microdiscectomy. Removes the portion of the disc pressing on the nerve.
• Laminectomy. Removes a portion of bone and ligament to relieve pressure on the spinal cord or nerves caused by narrowing of the spinal canal.
• Spinal fusion. Joins two or more vertebrae to correct painful movement between the bones, add stability and fix structural problems.
• Disk replacement. Removes a damaged or degenerated disc and replaces it with an artificial device.
• Kyphoplasty. Treats compression fractures by using a balloon to open a space that is then filled with surgical grade bone cement.

It’s important to know surgical options are available for neuropathic back pain while remembering most cases are uncomplicated and will resolve on their own. All you have to do is manage the pain, keep moving and reduce the risk of future episodes by keeping your back and core muscles strong, maintaining proper posture and using correct lifting techniques.

This content is not AI generated.