If you’re dealing with back pain, you’re not alone with an estimated 75-85 million Americans experiencing some form of back pain during their lifetime. Back pain is:
*one of the most common neurological ailments in the U.S.,
*one of the most common reasons people go to the doctor, and
*one of the most common causes of job-related disability.
Some factors that put us at risk for back pain include:
- advancing age,
- low fitness level,
- overweight,
- smoking,
- job (with physical exertion or many hours of desk work),
- race (African American women and Caucasian women of northern European heritage), and
- heredity.
Though most back pain resolves in time, there are some signs that indicate an immediate need to see a doctor. If you experience any of the following, see your doctor right away:
- numbness or tingling;
- pain that goes down your leg below your knee;
- severe pain that doesn’t improve with rest within 3 days or pain so intense you can’t move round;
- pain after a fall or injury;
- pain plus any of these problems:
- trouble urinating;
- numbness in your leg, foot, groin, or rectal area;
- nausea, vomiting, stomachache;
- weakness;
- sweating;
- fever; or
- unexplained weight loss.
When seeing your doctor, be prepared to answer questions about your medical history, and expect a physical exam that will likely include standing, walking, checking reflexes, applying pressure and checking for tender points on your back, and checking for muscle strength and sensation as well as for signs of nerve root irritation. Your doctor may also recommend diagnostic tests, which may include x-ray, MRI, bone scan, nerve studies (e.g., electromyography [EMG]), and/or blood tests. Most back problems respond to nonsurgical treatments, such as anti-inflammatory medication, ice, heat, exercises that strengthen back-supporting muscles, and physical therapy. You can also talk with your doctor about other conservative treatments, which may include intermittent use of a back brace, electrical stimulation, spinal manipulation, and/or cognitive behavior therapy.
When conservative treatments don’t help, back surgery may offer relief; however, it doesn’t help every type of back pain. In fact, it is only needed in a small percentage of cases.
Most people will have back pain sometime during life, and about 90 percent of these people will get better without treatment or with conservative therapies within 4-6 weeks. Only about 5 percent of those with back pain remain disabled longer than 3 months. In most situations, an operation won’t be considered unless conservative measures have failed, and even then it’s not often indicated. Back surgery is usually reserved for times when a nerve is pinched, the spinal cord is compressed, or there’s too much movement between the spinal bones. There are currently no effective surgical techniques for muscle- and soft-tissue-related back pain. So, be sure to give conservative approaches a try along with some time. If these approaches don’t help, talk with your doctor and weigh the pros and cons of surgery or other invasive treatments. Your preferences, concerns, and lifestyle play a large role in determining the best choices.
