When Should You Be Concerned About Lower Back Pain

Pain in the lower back usually comes from a problem with one or more parts of the lower back, such as the muscles and joints. Over-the-counter (OTC) pain medications, an ice pack, and rest are often used to alleviate this pain. However, although most back pain goes away by itself, there are situations when simply staying at home isn't a smart move.

The majority of back pain cases are acute or short-term, lasting anywhere from a few days to a few weeks. Other cases are chronic in that they persist for at least three months and, in some cases, even after medical care. There are several back pain issues that will require urgent attention, as well as, in some cases, surgical intervention.

But how do you know when the aching pain in your lower back is a cause for concern?

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When is lower back pain potentially a sign of a more serious condition?

What if your lower back pain persists?  Is that potentially a sign of a more serious condition? How can you know when your lower back pain has progressed from a little annoyance to a full-blown emergency?

Well, if your lower back pain lasts longer than two weeks and prevents you from engaging in your typical daily activities, you should contact your primary care physician for treatment. Although lower back pain is quite prevalent, some symptoms are abnormal and need immediate care.

It is important to seek medical attention if you also have the following symptoms:

  • Pain that radiates down the front, side, or back of your leg, or it might feel like it's confined to your lower  back

  • Lower back pain, pelvic pain, and hip pain due to muscle spasms and tension

  • When physical activity aggravates the pain

  • An inability to maintain a comfortable upright posture

  • Sustained pain

When should you see a doctor for your lower back pain?

Lower back pain can manifest itself in various ways, ranging from a dull ache to excruciating pain. It can last from days to weeks. There are a variety of home treatments you can try to alleviate the pain, depending on the severity. For instance, when your lower back initially begins to ache, you can start by taking over-the-counter pain medication or using ice/heat on your back for the first 48 hours.

Acute lower back pain most often means discomfort or pain that occurs suddenly. Acute back pain may be caused by a variety of factors, including stress, excessive activity, unnatural movements, or improper lifting.

Most lower back pain is classified as acute, which usually lasts no more than six weeks. The underlying source of the pain doesn't always cause major or long-term concern.

In contrast, chronic back pain may be life-threatening. A person who has chronic pain is at risk because the symptoms are strong enough to have an effect on their health, movement, and quality of life for a long time.

Unlike acute back pain, chronic lower back pain develops gradually and lasts for more than six weeks. Chronic back pain may also be recurring, which means that it will go away for a while but then return.

What factors lead to the emergence of chronic back pain? While a new injury might induce chronic lower back pain, it is caused by preexisting conditions the majority of the time. One of the most prevalent causes is muscle deconditioning which is a lack of strength and stability in your back.

But how do you know it's time to give up using home remedies and visit a medical professional?

The following warning signs are indicators that it is time to schedule that appointment:

You're suddenly losing weight

Do not overlook prolonged lower back pain, particularly if it's accompanied by unexpected weight loss.

The pain keeps you up at night

If finding a comfortable sleeping position seems difficult — or if the discomfort doesn't resolve when lying down — you should see your doctor. Back pain that occurs at night might be a sign of disc degeneration, a sprain, or something more severe.

You're experiencing pain following an accident

If you are involved in any form of a car accident or suffer any other kind of injury that causes lower back pain, you must get medical attention. You might have a more severe issue, such as a fracture, that has to be treated. Back pain, particularly in the lower back, may be a sign of a potential whiplash injury.

Who is at risk for lower back pain?

While anyone can suffer from lower back pain, some people are more susceptible to this than others. People with underlying health issues or unhealthy lifestyle practices are more likely to experience lower back pain.

Lower back pain is more common¹ as you get older. Because of the discomfort, you should seek medical attention immediately. There is an increased likelihood of infections and tumors in each of the upper age groups.

When is lower back pain an emergency?

Because lower back pain is so common, you may be tempted to dismiss your symptoms. However, if you have any of the following symptoms, you should seek medical attention immediately:

You can't control your bowel or bladder

If you are experiencing pain in your lower back and you lose control of your bladder or bowels, you should seek immediate medical attention. Some serious conditions, including spinal tumors and cauda equina syndrome, might be causing this discomfort. It might also point to lumbar spinal stenosis, which is a condition in which the nerves in the lower back are compressed.

Back pain with a fever

If you're experiencing a fever and achiness in your back, a few days of rest may be all that's needed to get you back on your feet. However, if the fever persists after using conventional OTC treatments, you may be suffering from a major infection that requires emergency medical attention.

You feel numb or weak

If you feel sudden, acute pain in your low back or leg, as well as numbness or muscular weakness in your leg, you must immediately see a doctor. This is particularly true if the pain continues after taking over-the-counter painkillers.

Spinal cord compression can manifest as motor weakness, numbness, or tingling sensations.

Extreme pain in your lower back may be a warning sign of a more serious underlying condition that needs immediate medical attention.

If you are experiencing any of the symptoms listed above, your situation may be connected to one of the back pain conditions listed below:

Cauda equina syndrome

Cauda equina syndrome is caused by damage to the cauda equina nerves. You may require rapid surgical intervention to decompress the nerves and prevent irreparable harm from occurring.

Cauda equina syndrome symptoms include intense pain in the lower back, motor weakness, pain in one or both legs, sensory loss, inability to feel anything in body parts that sit on a saddle, urine or bowel incontinence, sensory abnormalities in the bladder or rectum, and loss of reflexes in the extremities.

Aortic aneurysm

When an abdominal aortic aneurysm forms, it usually happens slowly and without any noticeable signs or with only minimal signs and symptoms, such as a pulsating abdominal mass, or stabbing pain deep in the abdomen between the sternum and the belly button. If the pain is intense enough, you may struggle to move or even straighten your upper body.

Abdominal pain can spread into the low back due to the aorta's proximity to the spine. You may also feel pain in your groin, pelvis, and/or legs.

Spinal tumor

Spinal tumors often form within your vertebral column. You may experience symptoms including numbness in the legs and arms, fever, and/or increased back pain all through the day.

Tumors may develop in the spine or extend from other body regions to the spine, where they are more prone to embed in the vertebrae due to the spine's extensive network of blood arteries. The tumor's location in the spine usually determines the back and leg symptoms.

Spinal infection

Spinal infection is a rare but potentially life-threatening condition that arises when bacteria, fungi, or viruses infiltrate the spinal cord and surrounding tissues. It occurs when bacteria from another infection move to the spine through the bloodstream.

The symptoms of a spinal infection vary depending on your age, infection severity, and spine location. You may have minimal symptoms at first but ultimately experience severe back pain. Sciatica-like symptoms, such as numbness, weakness, or paralysis, may arise in parts of the body below the infected location.

The lowdown

If you're having lower back pain that isn't alleviated by relaxation and self-care, it may be time to consult with a medical professional for assistance. Lower back pain is quite prevalent, and its causes are not usually immediately evident. On the other hand, lower back pain can occasionally indicate a more serious underlying illness, such as an infection or spinal concerns.

The primary cause of your lower back pain will most likely be determined through a physical examination and, if required, further investigations such as blood tests or imaging. Your doctor will then develop a treatment plan based on your diagnosis to help you manage your pain and keep it from interfering with your day-to-day life.

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