When to See a Doctor for Back Pain

By Justin Field, M.D.

 

Dr. Field is a board certified, fellowship trained orthopedic spine surgeon. Dr. Field has specialized training in minimally invasive spine surgery and motion sparing technologies, such as cervical and lumbar Artificial Disc Replacement, as well as non-fusion stabilization. In addition, he has extensive training in adult deformity correction and treatment.

 

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For many people, back pain feels like a normal part of life. It’s estimated that 75% to 85% of Americans experience back pain at some point. Back pain appears in different forms, ranging from a dull ache to shooting pain. Most back pain occurs in the lower back, known as the lumbar region. Half of patients with low back pain episodes will experience recurrent episodes in a year.

While most back pain resolves on its own and isn’t a sign of something serious, it should be looked at by a doctor in some cases. Your back consists of a spine, muscles, tendons and nerves, so it can be hard to figure what’s causing the pain on your own. If you don’t know what’s causing the pain, you won’t know how to treat it.

By going to a doctor for back pain, you can take steps toward feeling better again. A doctor who specializes in spinal conditions can determine the cause of your pain and initiate an effective treatment. They can also treat a condition that might otherwise get worse with time.

So, how do you know when you should see a doctor about lower back pain? Let’s look at common causes of back pain and symptoms that call for a professional examination.

Common Causes of Back Pain

Many different factors can cause or contribute to back pain, from injuries to various diseases. Patients might remember a specific incident that led to their back pain or have no idea what’s causing their discomfort. While there are dozens of conditions that can make someone’s back hurt, some are much more common than others.

Here are common causes of back pain:

1. Herniated Disc

A herniated disc is an issue with one of the soft cushions, called spinal discs, that sit between the bones in your spine. Each spinal disc has a tough exterior. A herniated disc happens when the soft part of the disc pushes through a tear in its encasement. The bulging disc might aggravate nearby nerves and cause symptoms. Many people who have a herniated disc do not have symptoms or need surgery. When symptoms occur, someone might experience pain, burning, stinging or weakness or numbness in their limbs. For some people, having a herniated disc is a debilitating condition. For 90% of people, a herniated disc heals on its own. Sometimes, a herniated disc can lead to chronic back pain. In rare cases, an untreated herniated disc can cause permanent nerve damage.

 

2. Facet Joints

Your facet joints are small joints connected to your vertebrae that allow motion and stability in your spine. They are covered by cartilage to prevent friction and promote smooth movements. The facet joints located in your lower spine carry the most weight and sustain the greatest amount of stress. Over time, the facet joints’ cartilage can break down and lead to a condition known as facet joint syndrome. Facet joint syndrome is characterized by lower back pain, which may radiate through the buttocks and in your upper thighs. Lumbar facet joints account for up to 45% of low back pain. You may be able to treat facet joint pain with over-the-counter (OTC) pain relievers, topical treatments or physical therapy. However, if home remedies and physical therapy do not relieve your symptoms, you have other options. For example, you might ask a doctor about an endoscopic rhizotomy. An endoscopic rhizotomy is a least invasive surgical procedure that involves making a tiny incision and using a laser or radiofrequency probe to ablate pain-causing nerves around the facet joints. This procedure is the least invasive surgical treatment for chronic low back pain yet the most effective.

 

3. Sciatica

Sciatica is a term used to describe pain that travels along the sciatic nerve. Your sciatic nerve runs from your lower back down the side of each leg. Sciatica is often a symptom of a herniated disc. It can also happen due to normal wear and tear. A typical sign of sciatica is pain that radiates from the lower spine down the side of the leg. Sciatica pain can be mild to severe and usually affects only one side of the body. People also experience sciatica in different ways. One person might describe it as a jolt or an electric shock feeling, while another may experience a mild ache. Sciatica usually gets better without treatment, but doctors can help patients manage pain and reduce inflammation. In some cases, surgery is needed to address the cause, such as a herniated disc.

 

4. Degenerative Disc Disease

Degenerative disc disease is not actually a disease but a condition where the wearing down of a spinal disc causes pain. When spinal discs wear down, the spine’s vertebrae rub against each other, causing pain and stiffness. Spinal discs break down over time as a natural part of the aging process. Most people over 40 have some form of disc degeneration. Degenerative disc disease mainly affects the lower back and neck. The pain might feel like tightness or numbness and radiate to the limbs. The pain may also come and go and feel worse when sitting or after lifting, bending or twisting. Although there is no cure for degenerative disc disease, there are treatments available to relieve symptoms such as an endoscopic discectomy or a minimally invasive spinal fusion.

 

5. Muscle Spasm

A spasm is an involuntary contraction and tightening of a muscle. Muscle spasms are very common and can affect any muscle in the body. Although muscle spasms typically occur in the calves, feet, hands and thighs, they can also happen in the back. A back muscle spasm appears suddenly and feels like tightening and pain. An injury, overuse or spine disease can cause a muscle spasm in the back. You might find that sitting, sleeping in an uncomfortable position, bending, lifting or standing causes a muscle spasm in your back. Sometimes, it’s hard to tell what led to the spasm, but most people can recall the activity that brought on the pain. You can treat a muscle spasm at home by taking OTC medicine, applying heat or ice, and avoiding the activity that causes the spasm. If it doesn’t get better, a doctor can recommend the next step.

 

6. Spinal Stenosis

Spinal stenosis is a condition defined by a narrowed spinal canal. When the spinal canal narrows, it adds pressure to nerves and the spinal cord, causing back pain, sciatica and numbness or weakness in the legs. Spinal stenosis is common in older adults and typically arises from disc degeneration and osteoarthritis. As discs and cartilage wear away in your spine, your body tries to make up for the loss by developing new bone, called bone spurs. Eventually, the bone spurs cause the spinal canal to narrow. Treatment for spinal stenosis generally focuses on relieving symptoms. If the condition causes difficulty walking or poor quality of life, patients might explore surgical treatment options. Spinal stenosis is the leading cause of spinal surgery in people over 65.

 

7. Sprain or Strain

A sprain is when a ligament tears or stretches, while a strain happens when a muscle or tendon gets pulled or twisted. Sprains and strains are the most common causes of back pain. Anyone can injure their back by lifting heavy objects, especially if they do not lift properly. It’s also possible to strain your back simply by sneezing or coughing. When someone has a back sprain or strain, the pain might worsen when they move. This can make it difficult to walk, bend or stand straight. A strain or sprain can also lead to muscle spasms. A back sprain or strain typically resolves in about two weeks. If pain continues, the person might need treatment.

 

8. Scoliosis

Scoliosis is an S-shaped or C-shaped spine curve. Scoliosis often appears in childhood and is mild for most people. In over 80% of cases, the cause of scoliosis is unknown. Other cases may be caused by hereditary factors or disc degeneration. Most children with mild scoliosis do not have any pain. However, adults who’ve had scoliosis since childhood are more likely to experience chronic back pain than the general population. Treatment for adults experiencing scoliosis-related pain aims to relieve symptoms and strengthen core muscles but not fix the curve. If scoliosis causes severe pain, a doctor might recommend surgery to improve the spine’s curves.

 

Additional Causes of Back Pain

Some of the following are less common causes of back pain but worth considering if you’re concerned about your symptoms:

• Infection
• Spinal fracture
• Sacroiliitis
• Spinal tumor
• Spondylolisthesis
• Osteoporosis
• Kidney stones
• Fibromyalgia
• Abdominal aortic aneurysm

How to Know When to See a Doctor About Back Pain

As mentioned earlier, most back pain improves in a few weeks with self-care and isn’t a cause for concern. Still, back pain can be debilitating, and some patients need a doctor’s help to cope with the pain or treat the problem with nonsurgical or surgical techniques. Back pain also can sometimes be a sign of a serious medical condition.

It’s a good idea to visit a doctor if you’re experiencing the following:

1. Nighttime Pain
For some people, lying down in bed makes their back pain worse, no matter what position they’re in. They might not have any back pain until they go to bed. Although nighttime back pain may be caused by common conditions like a sprain or scoliosis, it can be due to something serious, like an infection, fracture, nerve compression or spinal tumor. You should always get looked at by a doctor for any condition that disrupts your sleep.

2. Weakness, Numbness or Tingling
If you’re experiencing numbness, weakness or tingling with your back pain, you could have nerve damage or irritation. You should go to a doctor for nerve pain if it persists, especially if OTC pain relievers don’t help. If nerve pain does not get treated, it can lead to permanent damage.

3. Fever
A fever, along with back pain, can mean there’s an infection. Spinal infections include vertebral osteomyelitis, meningitis or a spinal epidural abscess. Spinal infections require immediate medical attention.

4. Unexplained Weight Loss
Unexplained weight loss along with back pain can be a sign of something serious. For example, weight loss and back pain are both symptoms of endocarditis. Endocarditis is inflammation of the heart’s inner lining and is a life-threatening condition. It’s rare in people with healthy hearts, but if it occurs, it requires emergency care.

Weight loss with back pain can also be a sign of cancer. Although spinal tumors are rare, you’ll still want to get checked by a doctor if you have unexplained weight loss with back pain.

5. Chronic Pain
If you’ve been experiencing back pain for more than a week, you should go to a doctor. A doctor can provide treatment to soothe symptoms and keep your back pain from becoming something serious.

6. Bowel or Bladder Control Problems
Severe low back pain with incontinence can be a sign of a rare but dangerous disorder called cauda equina syndrome. Cauda equina syndrome happens when nerve roots at the end of the spinal cord are compressed, affecting motor and sensory functioning. It may be caused by a large herniated disc in the lumbar region. Other possible causes include a spinal tumor or lesion, an infection or a violent injury.

Cauda equina syndrome is considered a medical emergency. If left untreated, it can lead to permanent paralysis.

7. Severe Pain
When should you go to a doctor for severe back pain? If your symptoms include severe back pain, you should visit a doctor, especially if the pain does not get better with rest or worsens over time. Likewise, if you experience back pain that shoots down your leg, you could have a damaged disc and should have a doctor evaluate you.

Even if you don’t have any of the above symptoms but experience back discomfort that disrupts your life, you should go to a doctor.

Medical Treatments for Back Pain

If back pain keeps you from doing the activities you enjoy or causes you significant discomfort, know that many different treatments are available to help you feel better. Back pain treatment falls under the following two categories:

Nonsurgical Treatments

Your doctor will likely recommend nonsurgical treatments for back pain before surgical options unless you have a serious condition. For example, they might suggest trying OTC pain relievers or topical creams first. They may prescribe a muscle relaxant if OTC medicines do not help.

If you continue to have pain after taking medicine, your doctor will recommend other nonsurgical treatments to relieve symptoms and restore functioning. For instance, they might administer a facet joint injection, which consists of local anesthesia and steroids and helps reduce inflammation and relieve pain. Facet joint injections produce results that can last for months.

Surgical Treatments

Usually, back pain can be treated successfully with nonsurgical options, but sometimes an injury or spinal condition requires surgery. A doctor might recommend surgery if other treatments do not work first. A doctor might also suggest surgery to treat bone spurs, a spinal infection, a fracture, a tumor or a degenerative spinal condition that’s causing problematic symptoms.

Learn More About At Home Remedies for Back Pain

If the idea of back surgery makes you feel nervous, know that there are a range of innovative, minimally invasive procedures available. Minimally invasive techniques offer many benefits over traditional surgery, such as shorter recovery times, less pain and reduced risk of infection.

One example of a least invasive surgical treatment is a Selective Endoscopic Discectomy™. This procedure involves a small incision and a thin endoscope to treat a herniated disc.

Who to See For My Back Pain?

If you’re still wondering if you should see a doctor for back pain, the short answer is yes. Going to the doctor for your back pain can help you find relief so you can enjoy life once again. At the Desert Institute for Spine Care (DISC), you can rest assured our doctors and staff will take good care of you.

At DISC, we believe every patient deserves compassionate, personalized care. We developed Personalized Pain Diagnostics (PPD) to identify the pain generator and most accurate diagnosis. With PPM we can personalize and tailor the right treatment or surgical option for our patients. We begin by asking questions and listening carefully to your experience. We then investigate your symptoms further through an examination and imaging tests.

Once we develop ideas about your pain, we will discuss them honestly and clearly with you and invite you to ask questions. We want to ensure you feel comfortable and can make an informed decision about your treatment.

When you’re ready, we’ll apply the latest technology to treat your pain and help you restore your lifestyle.

To learn more about our innovative treatments for back pain or schedule an appointment, please fill out our contact form or call one of our Phoenix-area locations today.

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