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When to Worry About Low Back Pain

When is back pain serious? Should you worry about back pain? Low back pain is the 5th most common reason that drives people to the doctor's office. Learn the tips on how to prepare for your doctor's visit. Also, learn about some of the more common causes of low back pain, in addition to the more concerning signs, symptoms, and treatments.

By
Sanaz Majd, MD,
Episode #233

Low Back Pain Red Flags

Thankfully, acute low back pain is common and typically self-resolving. Studies show that up to 90% of low back pain resolves within weeks.  

Thankfully, acute low back pain is common and typically self-resolving.

Despite its relatively benign nature, however, there are several rare and serious causes of acute low back pain that I must keep in mind when evaluating Lori:

Trauma:  If she had trauma precipitating the pain, I have to make sure there are no fractures or injuries.

Urine or bowel difficulties: Incontinence of either origin is especially important to know, so is a diminished ability to urinate.

Saddle anesthesia: Numbness or changes in sensation of the genitals or buttocks (which is why it's called saddle anesthesia).

Motor deficits:  Weakness with movement of either leg.

Fevers:  Infectious causes of back pain can cause fevers.

Unintentional weight loss:  Whether sudden or gradual weight loss, malignancy is a consideration (albeit a very rare cause of low back pain and more common in those with a history of cancer)..

History of cancer:  If you’ve had breast cancer, melanoma, prostate, lung, kidney, thyroid, and any cancer for that matter, it’s vital that you discuss your low back pain with your doctor right away.

Thankfully, Lori hasn't experienced any of this. These red flags are more worrisome and truly warrant an urgent and/or possibly emergent evaluation. 

And of course any pain that is persistent, becomes chronic, or becomes more severe throughout time warrants a doctor visit, as well. It's always better to get checked out.

So we’ve gathered the vital components of Lori’s low back pain experience, we’ve reviewed the anatomy of the lumbarsacral spine, and the more serious red flags that require immediate attention. In the next episode, I’ll review the causes of low back pain, explain how sciatica can play a role, discuss imaging considerations, and finally the treatment grand finale.

Please note that all content here is strictly for informational purposes only.  This content does not substitute any medical advice, and does not replace any medical judgment or reasoning by your own personal health provider.  Please always seek a licensed physician in your area regarding all health related questions and issues. 

Image courtesy of Shutterstock.

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