Low back pain remains one of the most common reasons for visits to the family doctor. The world health organization has estimated that 90% of people will develop low back pain at some point in their life. Of those, almost 80% will have a recurrent or chronic back pain.
Symptoms of low back trouble can vary from localized pain in the spine to radicular pains that can include numbness and tingling as far down as the toes. Symptoms can feel like pressure, burning, cold, or stiffness. Many have described it as a toothache type pain in the leg! Pain can be minimal and also incapacitating! With such common problem and wide range of symptoms, how do you know when it’s something truly serious versus a minor muscle strain from exercise?
As with any other muscle and joint aches and pains in the body, our spine is susceptible to straining muscles, overstretching joints, and general fatigue. This leads to inflammation that of course, causes a general ache. You may have a minor case of low back pain if:
- Symptoms are mild to moderate at most with signs of improvement almost daily and certainly weekly.
- Pain should be near the lumbar and pelvis regions but may be referred to the front of the hips and thighs or back of the leg.
- Symptoms can typically be correlated to previous activity within 1-2 days of onset. This might include physical exertion but could also be caused by something as simple as a long car ride.
For this type of minor pain gentle stretches and walking are often helpful. Bedrest is rarely indicated and has not been shown to be helpful for more than 1-2 days. Typical healing time for most minor lumbar injuries is 1 to 2 months with weekly improvements observed. Adequate strength and flexibility as well as utilizing good body mechanics are best at preventing this type of pain.
In more serious cases of back pain, nerves can be pinched by disc problems or even bony spurs. A visit to your general practitioner/MD is warranted if any of the following are present:
- Worsening low back and or lower extremity pain. If each day seems to be worse than the previous day, consulting your physician is advised.
- If you have partial weakness in any part of the leg or foot
- If pain is unmanageable or significantly affecting your function for more than 1-2 days without any sign of improvement.
Sciatica is pain that usually starts in the back or buttock and radiates into the leg and sometimes foot with numbness and tingling. This might be present with or without weakness in the affected region. In the absolute worst cases of low back pain, an emergency room visit may be warranted if any of the following occur in conjunction with the episode of low back pain:
- Loss of control of bowel and or bladder function. This can mean that there has been spinal cord damage and requires medical evaluation ASAP.
- Spinal cord injury may also be indicated if you lose control in one or both of your legs. For example, your leg will not support you or is randomly giving out.
This article is not meant to be an exhaustive list of indications to seek medical advice only to help in possible determination of minor vs. a more serious issue.
If you are unsure at any time about lumbar symptoms, consult your physician!
Shawn Babcock, Pivot Physical Therapy
