One of the most common causes of visits to the doctor is for treatment of back pain. Hopefully, if you are active, doing the CORE exercises we discussed, and doing your exercises properly, you will not get back pain. But if it does occur, what should you do? Jump into your car and go to the emergency room? NO NO NO NO NO!
The good news is that the vast majority of back pain, although uncomfortable or even painful, is not serious, and is usually of short duration. The only time you should go to the emergency room for back pain is if you experience:
1) Back pain with fever
2) Back pain with loss of control of your bowels or bladder
3) Back pain with sudden onset of true weakness in your extremities
4) Back pain associated with fairly severe trauma
5) Back pain that is extremely severe and debilitating and you literally cannot wait to get in to see your doctor
All other back pain can and should be evaluated by your primary care physician.
“What will my doctor do to evaluate my pain?”
He or she will ask you some questions about the back pain, evaluate your past medical history, and examine you. Unless you have:
1) A fever
2) Trauma leading to back pain
3) Weakness in your extremities
4) Loss of control of bowels or bladder
5) History of cancer
6) Been treated conservatively without any improvement
Your doctor probably will NOT order an X-ray. Most cases of back pain are not serious and are temporary, so X-rays are only indicated in the above circumstances.
“What is conservative therapy?”
Conservative therapy consists of pain medication like Advil, Tylenol, or Tramadol, maybe a muscle relaxer, heat, and supervised physical therapy. Over 95% of back pain will go away with these measures. The therapist should also advise you on posture, lifting and the CORE exercises we discussed, to decrease the risk of recurrence of back pain. If the above measures do not help, X-rays, MRI, and consultation may be indicated, depending on your situation.
Narcotics, both short and long-term, are rarely necessary for back pain. Also, back braces are very rarely indicated for back pain as they will weaken your CORE muscles and in the long run, may make back pain worse.
