Issue Date: November 19, 2006
Back pain primer
Know when it's time to head to the doctor.
Sometimes back pain can be a symptom of a serious illness.
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Many of us have lower back pain on occasion, and the discomfort usually is short-lived. But in some folks, back pain can signal more serious illness, so it helps to be able to distinguish the simple from the significant.
Remember that back pain is a symptom, not a diagnosis. Problems in many organs can manifest themselves as back pain. And even the back itself can have a variety of problems. Some of these don't require more than the tincture of time, but others need intervention right away. The following are some of the "red flag" symptoms that require evaluation by a doctor:
Sudden, severe back pain in someone who has been healthy. If you haven't been prone to back pain and a spell hits you hard and fast, it's important to have a doctor evaluate the underlying structures.
Back pain with minimal activity. If you experience back pain after performing a light activity -- such as bending over to pick something up -- you may need to get checked. Generally, older people and older women, in particular, are more likely to have osteoporosis (a thinning of the bones) and are at higher risk for developing what is called a compression fracture of one of the vertebrae in the back.
Pain that moves. If you have pain that radiates from the lower back (especially sharp, shooting pain through the buttocks toward the back of the leg), you may have a disc that's herniated or ruptured.
Back pain associated with weakness. If you experience an episode of back discomfort that's accompanied by significant weakness in an extremity, see your doctor. Left untreated, the weakness could become permanent.
Numbness. Although many people with lower back problems will experience numbness from time to time, it's best to let your doctor decide when this needs to be addressed medically.
Low back pain accompanied by fever. Fever can indicate infection or inflammation, and when it accompanies episodes of back pain, visit a physician to make sure no underlying problems need to be treated.
Loss of bladder or bowel control. These systems are regulated by nerves from the spine, and the body's inability to control these systems indicates that there may be some serious underlying pathology.
Prolonged pain. If you have episodes of back pain lasting more than two weeks, take a trip to your doctor's office. Your physician can ensure that everything is anatomically OK and implement therapies to help you improve.
Tedd Mitchell, M.D., president and medical directorof Dallas' Cooper Clinic, writes HealthSmart every week.
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