When Do You Need to Worry About Lower Back Pain?

Low back pain is one of the most prevalent conditions affecting Americans today.

There are numerous reasons for this, ranging from sedentary lifestyles to the millions of office jobs that don't require one to stand and move their body throughout the day. According to studies done at George Town University, 65 million Americans report a recent episode of back pain. Back pain problems are among patients’ most frequent complaints to their doctors.

About 8 percent of all adults experience persistent or chronic back pain. Back pain is the sixth most costly condition in the United States. Healthcare costs and indirect costs due to back pain are over $12 billion per year. People with chronic back pain report significantly higher levels of psychological distress, including feelings of anger and depression, than those who have experienced only acute episodes of back pain.

Learn more about when you need to worry about lower back pain.

What are the Causes of Back Pain?

Back pain is a common condition that can have many causes. The most common type of back pain is mechanical. Common examples include pregnancy, muscle spasms, disc herniation, and trauma to the area like falls, accidents, and wrong exercise. There are other causes which include:

Arthritis: refers to degenerative changes of the joints and bones, most commonly osteoarthritis. Osteoarthritis of the spine occurs when degenerative changes begin in the facet joints. When there are degenerative changes (osteoarthritis) of the spine including facet joint osteoarthritis, sacroiliac joint osteoarthritis, spinal stenosis, and disc disease, this causes back pain. Additionally, osteoporosis causes compression fractures.

Inflammation: whether acute or chronic, can cause significant back pain. There is a specific type of back pain that persists because of an inflammatory process. Some examples include sacroiliitis (pain in the sacrum) and ankylosing spondylitis (fusion of vertebrae bones).

Oncologic: This is caused by lytic lesions to the spine, cancers of the marrow, or compressive nerve from adjacent space-occupying lesions (mass), often presenting as a pathological fracture.

Infections: Infections of the spine, discs, epidural abscesses, or muscular/soft tissue abscesses.

It is important to note, however, that many non-back-related disorders can result in pain that patients perceive in the back. Such conditions include biliary colic, infectious pneumonia, obstructive or infectious renal disease, cancers, constipation and small bowel obstruction. If you have these problems for a long period of time, see your healthcare provider.

What is the Next Step After Having Back Pain for a Few Days?

When your back hurts, it often feels like the pain will never go away. You can take some simple steps to get relief and speed up the recovery process. If your back pain is manageable, there are some things you can do to help reduce the pain.

Acute Low Back Pain (lasts less than four weeks)

Nonpharmacologic interventions: it’s best to start with nonpharmacologic interventions and then over-the-counter medications.

Exercise: traction, spinal manipulation, and physical therapy have shown some benefits. Non-steroidal anti-inflammatory drugs: (NSAIDs) like Ibuprofen and Aleve have moderate evidence of benefits. However, other pharmacologic interventions, such as diazepam and systemic steroids, do not seem to provide benefits.

Subacute (4-12 weeks) and Chronic (12 weeks and beyond)

If you have subacute low back pain, acetaminophen is unlikely to provide much relief. However, nonsteroidal anti-inflammatory drugs (NSAIDs), heat, and muscle relaxants are moderately effective at reducing pain. To maximize your benefit from these treatments, add physical therapy, acupuncture, and spinal manipulation.

If back pain lasts more than four weeks and is having an impact on your quality of life, you need to see a doctor. You may need imaging scans or even a referral to a specialist. Don't wait too long because there are serious diseases that can be prevented before they get out of hand. An example of a serious disease is cancer, so it's important that you don't ignore back pain.