Most of us experience back pain at some point in our lives. While most of these episodes resolve spontaneously without medical treatment, there are times when seeking the advice of a health care professional is appropriate. This question has been raised many times during our community education seminars so I would like to cover some of these important points. While most episodes of back pain that we see in the clinic do not require surgical intervention to resolve, prompt medical attention in certain instances can lead to a quicker, more complete recovery by allowing us to direct the patient to the most appropriate conservative care.
I would like to talk primarily about back pain and neurologic symptoms arising without any sort of trauma. While most episodes of this sort of back pain resolve spontaneously within 4 to 6 weeks, there are certain symptoms that should prompt medical attention. Back pain can come from the muscles of the spine only, and that type of back pain usually represents a sprain type injury and very often will resolve spontaneously. However in some instances symptoms can be caused by pressure on the neurologic structures of the spine, particularly the nerve roots that exit between each vertebrae in the spine. The symptoms that are commonly associated with this sort of problem include pain in one or both legs; numbness or tingling in the legs, groin, or buttocks; weakness of the legs; loss of control of the bowels or bladder or difficulty emptying the bladder. Any of these symptoms suggest that nerve compression or irritation may be occurring and should be evaluated by your healthcare provider. if you have weakness of your legs or bladder difficulties mentioned above, you may have a potentially serious problem and should be evaluated urgently. Less serious nerve compression or irritation very often can be treated without surgery, however an evaluation by an experienced physician with expertise in spinal disorders will help get your conservative treatment headed in the right direction.
The second category of back pain that should be evaluated, is any episode of back pain that persists longer than three months, even if it is not accompanied by the neurologic symptoms mentioned above. Very often this sort of back pain is caused by degenerative changes of the spine, and while surgery likely will not be necessary, well directed conservative care and lifestyle modifications can be tailored specifically to the particular problem. It is also important to exclude much more serious problems such as spinal tumors as a cause of back pain if it has been present for this period of time. Evaluation is especially important in those patients who have a prior history of cancer anywhere in their body.
Dr. Jerrel Boyer
