What are the 5 signs that indicate your back pain might be an emergency. How can you differentiate between normal back pain and a serious condition. When should you seek immediate medical attention for back pain.

Understanding Back Pain: Common Causes and Prevalence

Back pain is an extremely common condition that affects approximately 80% of adults at some point in their lives. While most cases are benign and resolve on their own, it’s crucial to recognize when back pain might indicate a more serious underlying condition.

In our 20s and 30s, back pain often stems from everyday activities such as:

• Prolonged sitting
• Lifting children
• Overexertion during exercise

As we enter our 40s and beyond, the causes of back pain tend to shift towards:

• Work-related injuries
• Early stages of arthritis
• Degenerative conditions

Given the prevalence of back pain, many individuals may dismiss symptoms that could potentially signal a medical emergency. It’s essential to be able to differentiate between normal, temporary discomfort and more serious conditions that require immediate attention.

When Is Back Pain Considered Normal?

Not all back pain is cause for alarm. In many cases, mild to moderate discomfort can be attributed to specific activities and will resolve on its own with proper care. Back pain is generally considered normal when:

• It can be linked to a specific activity, such as lifting or twisting incorrectly
• The pain subsides within 72 hours after rest and application of ice
• Symptoms are manageable and don’t significantly interfere with daily activities

However, if your back pain exhibits certain characteristics, it may be indicative of a more serious condition that requires medical attention.

5 Warning Signs: When Back Pain Might Be an Emergency

While most instances of back pain are not cause for immediate concern, there are several red flags that should prompt you to seek medical attention without delay. Here are five key signs that your back pain might be an emergency:

1. Sharp Pain Instead of a Dull Ache

A sharp, intense pain that differs from a typical dull ache could indicate a more serious condition. This type of pain may be a sign of:

• A torn muscle or ligament
• An issue with an internal organ in the back or side

2. Radiating Pain

Pain that “moves” or shoots to the glutes or legs may be a sign of nerve compression. This type of pain often indicates conditions such as:

• Sciatica
• Herniated disc
• Spinal stenosis

3. Sudden Weakness in the Legs

Experiencing sudden leg weakness in conjunction with back pain can be alarming. This symptom may be caused by:

• Compressed nerves in the spine due to conditions like sciatica or spinal stenosis
• In rare cases, it could be a sign of a stroke

4. Incontinence

Back pain accompanied by an inability to control bowel or bladder function is a serious concern. This combination of symptoms might indicate:

• Severe nerve compression
• A spine infection, such as discitis or meningitis

5. Numbness or Pins and Needles in the Groin or Glutes

This condition, known as saddle anesthesia, is a sign of a serious nerve or spine condition. If you experience this symptom along with leg weakness and incontinence, it could be indicative of cauda equina syndrome, a medical emergency that requires immediate surgical intervention to prevent permanent nerve damage.

Cauda Equina Syndrome: A Medical Emergency

Cauda equina syndrome is a rare but serious condition that requires immediate medical attention. It occurs when the bundle of nerves at the base of the spinal cord (cauda equina) becomes compressed, leading to a range of symptoms including:

• Severe low back pain
• Leg weakness or paralysis
• Loss of bladder and bowel control
• Numbness in the “saddle” area (groin, buttocks, and inner thighs)

Why is cauda equina syndrome considered a medical emergency? Early diagnosis and treatment are crucial to prevent permanent nerve damage. Patients typically require immediate surgery to decompress the affected nerves and minimize long-term complications.

Differentiating Between Emergency and Non-Emergency Back Pain

How can you determine whether your back pain requires immediate medical attention or if it’s a less serious condition? Consider the following factors:

• Onset of pain: Sudden, severe pain that comes on without an obvious cause may be more concerning than gradual onset pain.
• Duration: Pain that persists beyond 72 hours despite rest and home remedies may warrant medical evaluation.
• Associated symptoms: The presence of neurological symptoms (weakness, numbness, tingling) or changes in bowel/bladder function should prompt immediate medical attention.
• Pain severity: While pain perception varies, severe pain that significantly impacts your ability to function may indicate a more serious condition.

When in doubt, it’s always better to err on the side of caution and seek medical advice, especially if you’re experiencing any of the five warning signs mentioned earlier.

Common Back Conditions in Older Adults

As we age, the likelihood of experiencing back pain increases due to various factors, including wear and tear on the spine, decreased bone density, and reduced muscle elasticity. Some common back conditions that affect older adults include:

Degenerative Disc Disease

This condition occurs when the intervertebral discs that cushion the spine begin to break down, leading to:

• Chronic pain throughout the spine
• Stiffness and reduced flexibility
• Increased risk of herniated discs

Lumbar Arthritis

Arthritis in the lower back (lumbar spine) is a common cause of low back pain in older adults. Symptoms may include:

• Pain and stiffness, particularly in the morning or after periods of inactivity
• Decreased range of motion
• Potential nerve compression leading to radiating pain or numbness

Spinal Stenosis

This condition involves the narrowing of the spinal canal, which can put pressure on the nerves passing through it. Symptoms often include:

• Back pain that worsens with standing or walking
• Numbness or tingling in the legs
• Weakness in the legs or feet

While these conditions can be painful and debilitating, they typically do not require emergency medical intervention. Most patients with these conditions can be effectively managed through a combination of non-surgical treatments.

Non-Surgical Treatment Options for Chronic Back Pain

For many older adults experiencing chronic back pain due to conditions like degenerative disc disease, lumbar arthritis, or spinal stenosis, non-surgical treatments can often provide significant relief. Some common treatment options include:

Physical Therapy

A tailored physical therapy program can help:

• Strengthen the muscles supporting the spine
• Improve flexibility and range of motion
• Teach proper body mechanics to reduce strain on the back

Medications

Various medications may be prescribed to manage pain and inflammation, including:

• Nonsteroidal anti-inflammatory drugs (NSAIDs)
• Muscle relaxants
• In some cases, prescription pain medications

Injectable Anesthetics

For more severe or persistent pain, injectable treatments may be recommended:

• Epidural steroid injections to reduce inflammation around compressed nerves
• Facet joint injections to alleviate pain from arthritic joints in the spine

Complementary Therapies

Some patients find relief through alternative treatments such as:

• Acupuncture
• Massage therapy
• Chiropractic care

It’s important to note that the effectiveness of these treatments can vary from person to person, and a comprehensive treatment plan often involves a combination of approaches tailored to the individual’s specific condition and needs.

When to Consider Surgical Intervention for Back Pain

While most cases of back pain can be managed effectively with non-surgical treatments, there are situations where surgery may be necessary. Some indications for surgical intervention include:

• Severe, persistent pain that doesn’t respond to conservative treatments
• Progressive neurological symptoms, such as worsening weakness or numbness
• Cauda equina syndrome or other emergency conditions
• Structural abnormalities that require correction, such as severe spinal deformities

The decision to undergo surgery should be made in consultation with a spine specialist, taking into account the specific diagnosis, severity of symptoms, and overall health of the patient.

Preventing Back Pain: Tips for Maintaining Spine Health

While not all back pain can be prevented, there are steps you can take to reduce your risk and maintain a healthy spine:

Practice Good Posture

Maintaining proper posture, especially when sitting for long periods, can help reduce strain on your back. Consider these tips:

• Keep your feet flat on the floor when sitting
• Use a chair with good lumbar support
• Take regular breaks to stand and stretch

Exercise Regularly

Engaging in regular physical activity can help strengthen the muscles that support your spine. Focus on:

• Core-strengthening exercises
• Low-impact aerobic activities like swimming or walking
• Stretching exercises to improve flexibility

Maintain a Healthy Weight

Excess weight, especially around the midsection, can put additional stress on your lower back. Maintaining a healthy weight through proper diet and exercise can help reduce this strain.

Use Proper Lifting Techniques

When lifting heavy objects:

• Bend at the knees, not the waist
• Keep the object close to your body
• Avoid twisting while lifting

Quit Smoking

Smoking can contribute to disc degeneration and impair blood flow to the spine. Quitting smoking can help improve overall spine health and reduce the risk of chronic back pain.

By incorporating these preventive measures into your daily routine, you can help maintain a healthy spine and reduce your risk of developing chronic back pain. However, if you do experience persistent or severe back pain, don’t hesitate to seek medical advice to ensure proper diagnosis and treatment.

5 signs your back pain might be an emergency | Back and Spine | Orthopaedics and Rehab

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About 80% of adults will experience back pain in their lives, so it’s important to be able to identify the severity of your symptoms.

In our 20s and 30s, “normal” back pain often can be attributed to factors of daily life, such as sitting too long, picking up children, or overdoing it while exercising.  

In our 40s and older, work injuries and the beginnings of arthritis and degenerative conditions are more common.

Back pain is so common, in fact, that many patients shrug off symptoms that might indicate a medical emergency.

Approximately 80% of adults will experience back pain in their lives, so it’s important to be able to identify the severity of your symptoms and track how long the pain lasts.

If back pain can be associated with a specific activity, such as lifting or twisting wrong, and the pain goes away within 72 hours after resting and applying ice, it’s usually nothing to worry about. However, if pain creeps on gradually, appears suddenly, or doesn’t go away, you might have a more serious condition. 

5 sensations that might indicate a medical emergency

1. Sharp pain rather than a dull ache: This could indicate a torn muscle or ligament, or a problem with an internal organ in the back or side.
2. Radiating pain: This pain “moves” or shoots to the glutes or legs, which could indicate a nerve compression condition.

Radiating pain could be a sign of nerve damage.

3. Sudden weakness in the legs: Limb weakness can be caused by compressed nerves in the spine due to conditions like sciatica or spinal stenosis. However, sudden leg weakness could also indicate a stroke.
4. Incontinence: Back pain paired with inability to control the bowels or bladder might be a sign of serious nerve compression or a spine infection, such as discitis or meningitis.
5. Numbness or pins and needles in the groin or glutes: This is known as saddle anesthesia and is also a sign of a serious nerve or spine condition. 

If you have leg weakness, incontinence, and numbness together, you might have cauda equina syndrome, a serious illness characterized by spinal cord nerve damage. This is a medical emergency, and patients usually need surgery immediately to decompress the nerves and reduce permanent damage.

Related reading: Get help for back, neck, and leg pain caused by spinal stenosis

Other conditions that cause back pain in older adults

We often see a range of less serious but still painful spine conditions in seniors. Most patients with these conditions will not require surgery. Physical therapy, medication, injectable anesthetics, or a combination of treatments usually can control symptoms.

• Degenerative disc disease, which can cause whole spine pain, and lumbar arthritis, which usually causes low-back pain, commonly develop with age and are considered wear-and-tear conditions.
• Sacroiliitis is an inflammation of the joints that connect your spine and pelvis. This condition can cause pain in the low back, glutes, and upper legs.
• Ankylosing spondylitis is an inflammatory arthritis that causes patients’ spines to become inflexible, resulting in a continual hunched forward position and spine pain.
• We also check for adult degenerative scoliosis and kyphosis, spine-curving conditions that can result in back pain and weakness in the lower extremities.

Take an inside look at The Spine Center at UT Southwestern, where the multidisciplinary team of physicians, nurses, and providers delivers cutting edge treatment for back pain and spine-related injuries.

Rare, non-spine conditions that cause back pain

Occasionally, our spine team finds that a patient’s back pain is caused by an underlying condition that is not spine related. 

Kidney and digestive issues, including pancreatitis and gallstones, can cause low-back discomfort that patients might assume is spine pain. In women, uterine fibroids and endometriosis are notorious for causing core pain that can radiate into the back.

Rarely, we discover that a patient with sudden, severe back pain has experienced a ruptured aneurysm, which is a weakening and tearing of part of a blood vessel. This is a medical emergency because it causes internal bleeding that can lead to a heart attack or stroke. Similarly, aortic dissection – the tearing of an inner layer of tissue in the aorta, the main vessel carrying blood from the heart to the rest of the body – sometimes causes back pain and can be fatal if not immediately treated.

Research suggests the spine is also prone to receiving cancer cells that spread from other parts of the body. Batson’s plexus, a network of veins that connect the venous system and spine, might (for unknown reasons) direct spreading cancer cells to the spine. For example, prostate cancer has been known to spread to the spine.

Related reading: Prostate Cancer Awareness Guide

Existing patients may also schedule an appointment using MyChart.

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Why back pain requires a team approach to care

Whether back pain requires surgery or is manageable with conservative treatment, it’s important to see a spine specialist for diagnosis and care. The doctors at our Spine Center work as a team with experts in nerve, muscle, and bone conditions, as well as nurses and physical therapists who work closely with patients to manage symptoms and reduce the risk of recurrence.  

Each week, our multidisciplinary team meets to discuss challenging cases and educate each other on the latest research and techniques. Together, we see a range of patients with complex medical needs. For example, if a patient with a spinal infection is taking a medication that suppresses the immune system, such as immunotherapy for cancer, we work together to find an effective treatment that is safe for their unique needs.

Some medications or medical conditions put patients at greater risk for low bone density, fractured vertebrae, or back pain. In these cases, we get referrals from and collaborate with oncologists, hematologists, rheumatologists, mineral metabolism doctors, and primary care doctors to reduce patients’ risks and manage their symptoms. 

If you are worried about back pain, come see us for reassurance. The earlier you are diagnosed, the better your outcomes can be. 

If you or a loved one might benefit from a back pain consultation, call 214-645-8300 or request an appointment online.  

Laurie Zapatka was injured in a car accident 20 years ago and her condition became progressively worse. By the time she came to UT Southwestern, her mobility was severely limited. A day after posterior spinal fusion surgery, she was up and moving with “zero pain.”

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Causes and When to See a Doctor

Overview

About 80 percent of adults experience lower back pain at least once. Back pain is usually described as dull or aching, but can also feel sharp and stabbing.

Many things can cause sharp lower back pain, including muscle strains, herniated disks, and kidney conditions.

Muscle strain

Muscle strains are the most common cause of lower back pain. Strains happen when you stretch or tear a muscle or tendon. They’re usually caused by injuries, either from sports or making certain motions, such as lifting a heavy box.

Muscle strains can also cause muscle spasms, which may feel like sharp jolts of pain.

Other symptoms of muscle strain in your lower back include:

• muscle aches
• stiffness
• difficulty moving
• pain radiating into your buttocks or legs

Muscle strains usually go away on their own within a few weeks. In the meantime, you can try over-the-counter anti-inflammatory medications to help manage your pain. Using an ice pack or heating pad on your lower back a few times a day may also help.

Muscle strain is the most common cause of lower back pain, but several other conditions can also cause it.

Herniated disk

A herniated disc, also known as a slipped disc, happens when one of the discs that sits between your spinal bones ruptures. Slipped discs are common in the lower back, and sometimes put pressure on the surrounding nerves, causing a sharp pain.

Other symptoms include:

• pain and weakness in the lower back
• numbness or tingling
• pain in your buttocks, thighs, or calves
• shooting pain when you move
• muscle spasms

Sciatica

The sciatic nerve is your largest nerve. It spans your lower back, buttocks, and legs. When something like a herniated disc puts pressure on it or pinches it, you might feel a sharp pain in your lower back with pain radiating down your leg.

This is known as sciatica. It usually only affects one side of your body.

Other symptoms include:

• mild to excruciating pain
• a burning sensation
• an electric shock sensation
• numbness and tingling
• foot pain

If you’re having trouble finding relief from sciatica pain, try these six stretches for relief.

Compression fracture

A compression fracture in the lower back, also known as a vertebral compression fracture, happens when one of your vertebrae breaks and collapses. Injuries and underlying conditions that weaken your bones, such as osteoporosis, can cause it.

Symptoms of a compression fracture vary depending on the cause, but usually include:

• mild to severe back pain
• leg pain
• weakness or numbness in the lower extremities

Spinal conditions

Some spinal conditions, such as spinal stenosis or lordosis, can also cause sharp lower back pain in both adults and children. Spinal stenosis causes the spaces in your spine to narrow, causing pain.

Lordosis refers to the natural S-shaped curve of your spine. However, some people have a more dramatic curvature that causes pain. Learn more about other spinal conditions that might cause pain.

Additional symptoms of a spinal condition include:

• tingling or numbness in the legs or feet
• lower back pain
• cramping in the legs
• weakness in the legs or feet
• pain when moving

Infections

Spinal infections can also cause sharp pain in your lower back. People often associate tuberculosis (TB) with the lungs, but it can also infect your spine. Spinal TB is rare in developed countries, but people with compromised immune systems have a higher risk of getting it.

You can also develop an abscess on your spinal cord, though this is also rare. If the abscess is large enough, it can start to put pressure on nearby nerves. Several things can cause this, including surgery complications or injuries involving a foreign object.

In addition to sharp pain that may radiate to your arms and legs, spinal infections can also cause:

• muscle spasms
• tenderness
• stiffness
• loss of bladder or bowel control
• fever

Abdominal aortic aneurysm

Your aortic artery runs straight down the middle of your body. An abdominal aortic aneurysm happens when part of this artery’s wall becomes weakened and expands in diameter. This can happen slowly over time or very suddenly.

Symptoms include:

• back pain that’s sometimes sudden or severe
• pain in the abdomen or side of your abdomen
• a pulsating feeling around your abdomen

Arthritis

Many types of arthritis, including osteoarthritis (OA), can affect your back. When this happens, it causes the cartilage between your vertebrae to wear down, which can be painful.

Additional symptoms of arthritis in your back include:

• stiffness that goes away after moving
• pain that gets worse at the end of the day

For relief, try these gentle exercises for arthritis back pain.

Kidney conditions

Sometimes you can feel pain from your kidneys in your lower back, especially if you have kidney stones or a kidney infection. You’re more likely to feel kidney-related back pain on one side.

Additional symptoms of a kidney problem include:

• fever and chills
• pain during urination
• frequent urination
• pain in your side or groin
• smelly, bloody, or cloudy urine

Endometriosis

Endometriosis happens when uterine tissue starts growing in parts of the body other than the uterus, such as the ovaries or fallopian tubes. It can cause severe abdominal, pelvic, and lower back pain in women.

Other endometriosis symptoms include:

• severe pain during menstruation
• pain during or after intercourse
• infertility
• bleeding or spotting between periods
• digestive issues
• painful bowel movements
• painful urination during menstruation

Ovarian cysts

Ovarian cysts are small, fluid-filled bubbles that form in your ovaries. They’re fairly common and usually don’t cause symptoms. However, when they’re large, they can cause sudden pain in your pelvis that often radiates to your lower back.

Additional symptoms of ovarian cysts include:

• feeling of fullness or pressure
• abdominal bloating

Large ovarian cysts are more likely to rupture, which also causes sudden, severe pain. A ruptured ovarian cyst can cause internal bleeding, so call your doctor right away if you suddenly feel pain around one side of your pelvis.

Ovarian torsion

Sometimes one or both of your ovaries can twist, resulting in a condition called ovarian torsion. In many cases, the connected fallopian tube also twists.

Ovarian torsion causes severe abdominal pain that comes on rapidly and often spreads toward your lower back. Some women also have symptoms of nausea and vomiting.

Ovarian torsion is a medical emergency that requires treatment right away to avoid permanent damage to your ovary. While you’ll likely need surgery, most women regain full function of the affected ovary.

Uterine fibroids

Fibroids are muscular tumors that are almost always noncancerous. They can form in the lining of the uterus and cause lower back pain. Some are very tiny, while others can grow to the size of a grapefruit or larger.

Fibroids can also cause:

• heavy bleeding
• painful periods
• lower abdominal swelling

Pelvic inflammatory disease

Pelvic inflammatory disease (PID) is a serious condition caused by an infection of the female reproductive organs. It often develops when sexually transmitted infections, such chlamydia and gonorrhea, go untreated.

Symptoms are often mild or unnoticeable, but you may experience:

• pain in lower abdomen
• foul-smelling vaginal discharge
• pain or bleeding during sex
• fever

If you think you have PID, contact your doctor immediately. You’ll need to start taking antibiotics right away to avoid possible complications, such as infertility or an ectopic pregnancy.

Pregnancy

Up to 50 percent of pregnant women experience some type of lower back pain. It’s usually felt as pelvic girdle pain or lumbar pain.

Pelvic girdle pain, which is about four times more common than lumbar pain among pregnant women, causes sharp, stabbing pain in the lower back.

It can also cause:

• constant pain
• pain that comes and goes
• pain on one or both sides of lower back
• pain that shoots down to the thigh or calf

Lumbar pain in pregnant women resembles other chronic lower back aches in nonpregnant women. Both types of back pain typically resolve within the first few months after delivery.

Warning

1. Lower back pain is sometimes a symptom of a miscarriage when accompanied by spotting, bleeding, or unusual discharge. Other things can cause these symptoms, but it’s best to check in with your doctor.

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Prostatitis

Prostatitis is a common condition that causes inflammation in the prostate, often due to a bacterial infection. Some cases don’t cause any symptoms, but others can cause lower back pain as well as:

• pain in the groin, penis, scrotum, anus, or lower abdomen
• pain during or after ejaculation or urination
• increased urge to urinate
• fever

Prostate cancer

Prostate cancer is cancer that begins in the prostate, a small gland near the bladder that produces fluid for semen.

In addition to lower back pain, it can also cause:

• urinary problems
• painful ejaculation

Learn more about prostate cancer, including risk factors and screening guidelines.

Lower back pain usually isn’t a medical emergency. Chances are, you strained muscle. But, if you’re pregnant or have any of the following symptoms, contact your doctor as soon as possible:

• fever or chills
• urinary or bowel incontinence
• severe pain that doesn’t respond to over-the-counter treatments
• a pulsating feeling in the abdomen
• nausea or vomiting
• difficulty walking or balancing

Lumboischialgia – causes, treatment | MOTRIN®

Author, editor and medical expert – Anna Yurievna Budovskaya.

Editor and medical expert – Harutyunyan Mariam Harutyunovna

Number of views: 35 841

Last update date: 12/29/2022 9 0003

Average reading time: 6 minutes

Content:

Causes of sciatica
Symptoms of sciatica
Diagnosis of lumboischialgia
Treatment of lumboischialgia
Prevention of lumboischialgia

Pain in the lower back during life occurs in more than 70% of people, most often in young people aged 35 to 55 years. Lumbosacral pain is one of the most common causes of temporary disability ^1.2 .

Pain in the lower back is called variously ³ :

• lumbalgia – if it is felt only in the lower back;
• lumboischialgia – when pain occurs not only in the lumbar region, but also spreads to the lower limb;
• lumbago – in cases where there is acute and intense pain in the lower back (lumbar backache).

In all these cases, back pain is a serious symptom that requires alertness and a mandatory visit to a doctor. In this article, we will talk in detail about lumboischialgia: why it occurs, how to alleviate unpleasant symptoms and prevent their recurrence.

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Causes of lumboischialgia

In more than 90% of cases, doctors do not find any serious disease (inflammation, infection, tumor, or fracture) that could cause lumboischialgia attacks ² . The most common causes of pain are complications of lumbar osteochondrosis, such as displacement of the vertebrae or a herniated disc ³ . In the elderly, lumboischialgia is usually due to degenerative processes (disc destruction) in the lumbar spine ^2.9 , and in young and middle-aged people it is often due to reflex irritation of the nerves, for example, when the intervertebral disc bulges ^9.12 .

Intervertebral discs are structures that serve as shock absorbers during the movement of the spine. Each disc has a nucleus pulposus and a fibrous (dense) annulus that prevents the nucleus from going beyond the disc ¹³ .

In a herniated disc, the intervertebral disc moves outward and irritates the pain receptors of the annulus fibrosus. This causes reflex muscle spasms, which provoke pain in the lower back and lower limbs ⁹ .

At risk of developing lumboischialgia are people whose work is associated with lifting weights or “twisting” loads that are inadequate for the spine. Such movements during work are usually performed by loaders, locksmiths, as well as athletes – gymnasts, tennis players, skiers ¹¹ . However, osteochondrosis and its complications in the form of lumboischialgia are also often found in people of “sedentary” professions, for example, office workers and drivers of vehicles who are forced to stay in one, sometimes very uncomfortable for the spine, position for a long time.0035 11 .

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Symptoms of sciatica

Lumbosciatica can occur due to sudden movement, bending over, lifting heavy objects or falling ⁹ . For many, the pain is aggravated by straining, coughing, sneezing, staying in one position for a long time, and even sitting in a deep chair ⁹ . At the moment of the attack, the person takes a forced position, usually leaning to the healthy side, or lies with his leg pressed to his stomach to relieve pain ⁹ .

There are 2 forms of lumboischialgia:

• In neuropathic the source of pain is the root of the spinal nerve, which turned out to be compressed by a displaced vertebra or herniated disc ³ . When squeezing the root (radiculopathy), the pain is sudden, shooting and intense ³ . Since the sciatic nerve is part of the root ¹⁴ , the pain “radiates” to one leg, but does not have clear boundaries and can “move” within the lower limb ³ .
• Reflex occurs due to irritation of the muscles, joints and ligaments in the lumbar region ¹¹ . At the same time, aching and more often bilateral pain is observed, which is most pronounced in the buttocks and thighs, rarely goes below the knee ³ . Sometimes discomfort is felt constantly ³ .

Consult your doctor if you experience any pain. Often low back pain is a manifestation of specific conditions that require emergency care ³ .

The following danger symptoms (“red flags”) are distinguished for lumboischialgia ² :

• under 18 and over 50 years of age;
• recent back injury;
• long-term treatment with hormonal drugs;
• dramatic weight loss;
• persistent progressive pain that does not improve with rest;
• soreness, which is felt not only in the back, but also in the perineum, vagina, rectum, sometimes associated with urination or defecation;
• increased body temperature;
• marked spinal deformity.

If on the background of lumboischialgia you have found at least one “red flag” – immediately seek help from a specialist ⁵ .

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Diagnosis of lumboischialgia

Pain in the lumbar region radiating to the gluteal region and the leg (or both legs) may be a manifestation of acute lumboischialgia (lasts up to 6 weeks) and chronic (troubles more than 12 weeks ) ³ . Often it goes away on its own ⁵ , but in order for the problem not to become chronic, you need to be examined by a doctor in time and exclude serious diseases.

If you have frequent symptoms of sciatica, you should contact your general practitioner. If necessary, he will refer you to a neurologist, traumatologist, rheumatologist and other specialists ² .

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Treatment of lumboischialgia

Pain relief is one of the important tasks of the syndrome therapy ¹¹ . For this purpose, non-drug, medical and surgical methods can be used ^{8. 11} .

For symptomatic treatment of acute and chronic sciatica, non-steroidal anti-inflammatory drugs are used ^4,6,11 , which relieve pain and increase the functional activity of patients ¹¹ . Motrin® is a drug from the NSAID group, the active ingredient of which is naproxen. The drug is indicated for adults and adolescents from 15 years of age with lumboischialgia as an anesthetic ⁷ .

Tablets should be taken whole (including with meals) and washed down with a sufficient amount of liquid ⁷ . To relieve the pain of sciatica, you can take as follows: starting dose – 2 tablets (500 mg), and then one tablet (250 mg) up to 4 times a day (every 8 hours). In this case, usually the daily dose used to relieve pain is 2-3 tablets (500-750 mg). It is allowed to use the drug as an anesthetic without consulting a doctor for up to 5 days. If unpleasant symptoms persist or worsen, be sure to consult a specialist ⁷ .

Non-drug methods of pain relief include ^3.8 :

• therapeutic exercises;
• manual therapy;
• acupuncture;
• massage.

If there is pain in the lower back that radiates to the leg, experts recommend maintaining physical activity and avoiding bed rest – this has a beneficial effect on the course of the pathology and helps to recover faster ^6,8,11 .

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Prevention of lumboischialgia

To prevent attacks of pain, it is important to follow the recommendations of doctors: 5 2 ;

Lumbosciatica is a problem that can affect both the elderly and young people ¹ . It indicates the resulting complications of osteochondrosis and requires careful attention ³ . With a properly organized work schedule, sufficient physical activity and timely access to a doctor, exacerbations and complications of chronic back pain can be avoided ¹¹ .

The information in this article is for reference only and does not replace professional medical advice. For diagnosis and treatment, contact a qualified specialist.

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References

1. WHO Priority diseases and reasons for inclusion 2013 6.24 Low back pain https : //www . who . int/medicines/areas/priority_medicines/Ch6_24LBP.pdf
2. Parfenov Vladimir Anatolyevich, Golovacheva Veronika Alexandrovna Diagnosis and treatment of acute nonspecific lumbosacral pain // Therapeutic archive. 2019. No. 8. URL: https : //cyberleninka . ru/article/n/diagnostika-i-lechenie-ostroy-nespetsificheskoy-o-krpoyasnichtsovoy-boli
3. Levin O. S., Chimagomedova A.Sh., Shugurova I.M., Nikitina A.N. Modern approaches to the diagnosis and treatment of chronic back pain // STPN. 2020. No. 3-4. URL: https : //cyberleninka . ru/article/n/sovremennye-podhody-k-diagnostike-i-lecheniyu-hronicheskoy-boli-v-spine
4. Shirokov Vasily Afonasevich, Potaturko A.V., Terekhov N.L. Non-steroidal anti-inflammatory drugs, muscle relaxants and vitamins of group B in the treatment of lumboischialgia // Neurology, neuropsychiatry, psychosomatics. 2020. №6. URL: https : //cyberleninka . ru/article/n/nesteroidnye-protivovospalitelnye-preparaty-miorelaksanty-i-vitaminy-gruppy-v-v-lechenii-lyumboishialgii
5. Shakhabov I.V., Polishchuk N.S. Evaluation of recommendations for the appointment of magnetic resonance imaging in the provision of outpatient care in a planned form for pain at the level of the lumbar spine // ORGZDRAV: News. Opinions. Education. Vestnik VSHOUZ. 2020. No. 3 (21). URL: https://cyberleninka. ru/article/n/otsenka-rekomendatsiy-po-naznacheniyu-…
6. Parfenov Vladimir Anatolievich, Isaikin A.I., Kuzminova T.I., Chernenko O.A., Milovanova O.V., Romanova A.V., Samkhaeva N.D., Shor Yu.M. Treatment of patients with acute and subacute lumbodynia and lumboischialgia // Neurology, neuropsychiatry, psychosomatics. 2019. No. 3. URL: https : //cyberleninka . en/article/n/lechenie-patsientov-s-ostroy-i-podostroy-lyumbalgiey-i-lyumboishialgiey
7. Instructions for use of the drug MOTRIN ® tablets //Reg.number P N002874/01// GRLS RF. – URL: https : //grls . rosminzdrav . en/Grls_View_v2.aspx?routingGuid=868bad0c-d10e-47a9-b9d8-2595d9a01ac7&t=
8. Parfenov V.A., Parfenova E.V. Questions of therapy of chronic nonspecific lumbalgia // MS. 2020. No. 8. URL: https://cyberleninka.ru/article/n/voprosy-terapii-hronicheskoy-nespetsif…
9. Shostak N.A., Pravdyuk N.G. Back pain and comorbidity – diagnosis, treatment tactics. Outpatient surgery. 2016;(3-4):44-50. https://www.a-surgeon.ru/jour/article/view/59
10. Vertkin A.L., Karateev A.E., Kukushkin M.L., Martynov A.I., Parfenov V.A., Yakhno N.N., Knorring G.Yu. National guidelines for the management of patients with back pain for internists and general practitioners of polyclinics. Therapy. 2018; 3 (21) https://therapy-journal.ru/ru/archive/article/36103
11. Russian Interregional Society for the Study of Pain. Clinical guidelines Diagnosis and treatment of musculoskeletal (non-specific) pain in the lower back, 2019https : //painrussia . en/educational-programs/2020/zoom/%D0%9A%D0%A0_%D0%91%D0%A1_%D0%A0%D0%9E%D0%98%D0%91_2020_%D1%84%D0% B8%D0%BD%D0%B0%D0%BB%20(1).pdf
12. Diagnosis of viscero-vertebral and vertebro-visceral pain syndrome in lumbar osteochondrosis. Drivotinov B.V., Gamanovich A.I., Medical Journal No. 4 2012 From 46-50.
13. Big Medical Encyclopedia (BME), edited by Petrovsky B.V., 3rd edition. Spine.https : //xn--90aw5c . xn--c1avg/index . php/%D0%9F%D0%9E%D0%97%D0%92%D0%9E%D0%9D%D0%9E%D0%A7%D0%9D%D0%98%D0%9A (accessed : 05.10.2021)
14. Big Medical Encyclopedia (BME), edited by Petrovsky B.V., 3rd edition. Sciatic nerve. https : //xn--90aw5c . xn--c1avg/index . php/%D0%A1%D0%95%D0%94%D0%90%D0%9B%D0%98%D0%A9%D0%9D%D0%AB%D0%99_%D0%9D%D0% 95%D0%A0%D0%92 (date of access: 05.10.2021)
15. Frick et al. Efficacy and safety of naproxen sodium and ibuprofen for pain relief after oral surgery. Current Therapeutic Research. 1993;54(6):619-27.

Low back pain when moving, walking: causes, how to treat

The biggest load when walking falls on our lower back, since it is it that connects the upper body with the lower limbs, taking on a lot of weight and softening the shocks. If pain occurs in the lumbar spine, this is a sure sign of illness. Often people do not pay attention to the fact that the lower back hurts when walking, and do not understand the causes of the phenomenon, postponing the visit to the doctor until better times.

Causes of lower back pain when walking

The lumbar region is formed by five large vertebrae, between which there are discs that serve as a kind of shock absorbers. Nerve endings emerge from the vertebrae, creating plexuses of nerves that are responsible for walking and maintaining the vertical position of the body, the functioning of the abdominal organs. If your lower back hurts while walking, you should understand the causes and start treatment as soon as possible.

Heavy physical work

Serious physical activity contributes to premature wear of the structures of the spine, which leads to pain. Sometimes the pain is so severe that the person has difficulty even getting out of bed. This may be a sign of an intervertebral hernia.

Overweight

Since the lumbar region bears the weight of the upper torso and upper limbs, excess weight leads to an increase in the load. Therefore, overweight people are more likely than others to experience lower back pain when walking.

Pain classification

In general, there are several types of back pain. There are only three of them:

If there is a sharp paroxysmal and sharp pain in the lower back when moving, this is called lumbago. Sometimes you can hear the popular name for this phenomenon – backache. Lumbodynia refers to a condition in which there are constant, mild pains that can worsen during SARS, during physical exertion or sudden movements. Lumboischialgia is not just a condition when the lower back hurts when walking, but also the irradiation of pain along the sciatic nerve, as well as a feeling of “goosebumps” and numbness of skin areas.

Diseases and pathologies

To start treating back pain, you need to determine their cause. There are a large number of diseases that provoke the formation of pain syndrome.

Osteochondrosis

It is an overgrowth of cartilage near the discs of the spine and the vertebrae themselves, which causes pinching of the nervous tissue. This significantly reduces the mobility of the spine. The causes of the disease are overweight, low mobility, and malnutrition.

Curvature of the spine

If the spinal column is curved, pain in the lower back appears when walking. Otherwise, this phenomenon is called scoliosis; the disease varies in degrees depending on how severely the spine is curved.

Herniated disc

If the integrity of the fibrous ring, which holds the nucleus pulposus inside itself, is broken, an intervertebral hernia occurs. The tubercle presses on the nerve endings and the spinal cord, which causes severe pain.

Spinal stenosis

When moving, pain in the lower back occurs even if the space of the spinal canal is occupied by growing cartilaginous or soft tissues. Because of this, the nervous tissue is infringed, which provokes a violation of the functions of the limbs and the occurrence of pain.

Spondylolisthesis

Spondylolisthesis is a condition when one overlying vertebra is displaced in relation to the underlying one. Tumors, back injuries, degenerative processes in the spine, etc. can lead to this condition. Gradually, the spinal canal will narrow, and the pain will increase as the disease progresses.

Osteoporosis

If you are wondering “why does the lower back hurt when walking?”, The problem may also lie in osteoporosis. This disease leads to a general decrease in bone density, increased fragility and susceptibility to cracks and fractures even with minor stress and injury.

Injuries

Traumatic injuries are one of the most common reasons why the back in the lumbar region hurts when walking. Only a doctor can exclude the presence of an injury, who will most likely refer you for an X-ray examination. If you have recently hit or fallen, and now you feel pain in your back, you should not hesitate to visit a doctor.

How to relieve pain

If the lower back hurts a lot when standing and walking, it is not enough just to eliminate the pain, since it is only a symptom. It is important to identify the cause of the pain by contacting a doctor. Moreover, without a diagnosis, it is unlikely that it will be possible to prescribe an adequate treatment strategy that will lead to the elimination of the pain syndrome. If you experience severe pain, you can take painkillers that are sold in pharmacies without a prescription, as well as attach an ice pack or heating pad to the sore spot. It is worth knowing that complete rest may not bring positive results. Neurologists recommend that you lead a normal life as much as possible, but you should not engage in activities that provoke increased back pain. For example, if your lower back starts to hurt after a long walk, give up long walks and give yourself time to rest.

Diagnosis and treatment

If your lower back hurts after walking, only a doctor can prescribe the right treatment. He will conduct a survey and find out what kind of pain you are tormented by, when they appear, in what situations there is an aggravation.