When Should I Be Worried About Lower Back Pain?

Reviewed on 11/22/2021

While lower back pain is common but when it does not go away within 1 to 2 weeks, it may be a sign of something more serious such as abdominal aortic aneurysm, cauda equina syndrome, spinal tumor, spinal infection, or acute trauma.
While lower back pain is common but when it does not go away within 1 to 2 weeks, it may be a sign of something more serious such as abdominal aortic aneurysm, cauda equina syndrome, spinal tumor, spinal infection, or acute trauma.

Lower back pain is a common problem and it can often affect a person’s ability to perform everyday tasks. Most acute lower back pain is caused by injury or a disorder such as arthritis. Fortunately, lower back pain can often be relieved with home treatment.

In general, if lower back pain does not go away within 1 to 2 weeks, see a doctor. If you have any concerns about your lower back pain, see a doctor for a diagnosis and treatment plan.

Emergency Signs and Symptoms of Lower Back Pain

See a doctor immediately if you have signs and symptoms along with lower back pain that may indicate serious conditions such as: 

  • Abdominal aortic aneurysm
    • A rare, serious medical condition
    • Lower back pain that may also spread to the groin, pelvis, and/or legs
    • Severe, continuous, stabbing pain felt deep in the abdomen between the breastbone in the center of the chest and the belly button
    • A pulsating mass in the abdomen, which may be felt through the skin and is sensitive to touch.
    • Sudden and rapid heartbeat, shallow breathing, clammy skin and cold sweats, general weakness, confusion, anxiety, and/or loss of consciousness, indicating shock
  • Cauda equina syndrome
    • Can result in severe impairments in the lower back and leg(s)
    • Difficulty or inability to control bowel movements 
    • Urinary retention or incontinence 
    • Numbness in the groin, buttocks, genitals, and/or inner thighs (“saddle numbness”) 
    • Sexual dysfunction 
  • Spinal tumor
    • Persistent pain even with rest and medication
    • Fever and chills
    • Night sweats
    • Progressive or sudden motor weakness in the leg(s)
    • Unexplained weight loss
  • Spinal infection
    • Fever and chills
    • Pain worsens at night
    • Swelling, warmth, and redness around the infection site
    • Unexplained weight loss
  • Acute trauma
    • Leg pain and numbness
    • Inability to lift the foot (foot drop)
    • Complete loss of sensation in one or both legs indicating paralysis

What Causes Lower Back Pain?

There are many causes of lower back pain. Most of the time, lower back pain is a result of a disruption in the way the parts of the back (the spine, muscles, discs, and nerves) fit together and move. 

15 Possible Causes of Lower Back Pain

Serious causes of lower back pain include:

Other causes of lower back pain include:

How Is Lower Back Pain Diagnosed?

The cause of lower back pain is diagnosed with a patient history and physical examination of the back. The physical examination may also include a range of motion tests to check mobility as well as a neurological examination to check muscle strength, skin sensation, reflexes, and cranial nerves.

Additional tests used to diagnose the cause of lower back pain may include: 

  • Imaging tests
  • Electrodiagnostic tests
    • Nerve conduction studies 
    • Electromyography (EMG
    • Somatosensory evoked potentials (SSEP) if spinal cord dysfunction is suspected
  • Diagnostic injections to help pinpoint specific anatomical structures as the pain source
    • Facet joint injection
    • Medial branch block
    • Selective nerve root block
    • Lumbar sympathetic nerve blocks
    • Sacroiliac joint blocks
    • Stellate ganglion blocks

QUESTION

Nearly everyone has low back pain at some time during their life. See Answer

What Is the Treatment for Lower Back Pain?

It is important to see a doctor for a proper diagnosis of the cause of lower back pain so the proper treatment plan can be implemented. 

Home treatment to relieve lower back pain may include:  

  • Cold and hot compresses 
  • Gentle stretching
  • Bed rest for 1 to 2 days at most — activities should be resumed as soon as possible
  • Over-the-counter (OTC) pain relievers to reduce pain and discomfort 
  • Physical therapy
  • Acupuncture

Movement can be effective for relieving lower back pain, and strengthening back, abdominal, and leg muscles may help prevent lower back pain from recurring. Consult your doctor or physical therapist before performing any exercises for lower back pain. Depending on the cause of your lower back pain, some exercises may not be recommended.  If any exercises worsen the pain or cause new pain, stop and contact your doctor. 

If conservative home treatments and exercises are not effective in relieving lower back pain, medical treatments may include: 

  • Prescription medicines
  • Spinal manipulation and spinal mobilization such as chiropractic 
  • Transcutaneous electrical nerve stimulation (TENS)
  • Spinal injections
  • Implanted nerve stimulators 
  • Surgery in severe cases

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Reviewed on 11/22/2021
References
Image Source: iStock Images

https://orthoinfo.aaos.org/en/recovery/low-back-surgery-exercise-guide/

https://www.ninds.nih.gov/Disorders/All-Disorders/Back-Pain-Information-Page

https://www.ninds.nih.gov/disorders/patient-caregiver-education/fact-sheets/low-back-pain-fact-sheet

https://www.spine-health.com/blog/my-lower-back-pain-serious