December 28, 2020

Is It Time To See a Doctor for My Aching Back?

While lifestyle changes and home remedies can help, here are some signs it’s time to make a doctor’s appointment

man with back pain at doctors office

Lately, you’re back has been acting up. But you were sure it would calm down after a couple of days. Everyone gets this once in a while, right? After a certain point, you start to wonder whether you continue with the cold compresses or reach out to your healthcare provider.

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These may be some of the questions swirling in your head as you’re feeling your aching back pain continue or even worsen. Pain management specialist and anesthesiologist Kristin Powers, MD, breaks down how to know if your back pain needs medical attention.

When should I see a doctor for back pain?

Back pain can be caused by a variety of factors. Some people will have an exacerbation of back pain with no inciting event, and other times there is something very distinct that happened, like lifting a heavy object, or sleeping in an uncomfortable position, that triggered the pain. It is important to take note when symptoms become worse, more persistent or different.

Here are some signs that you should see a healthcare provider about your back pain:

If the pain isn’t going away

One of the best ways to know if you should see your provider for back pain is to keep track of how long you’ve been feeling the pain. Dr. Powers points out that acute pain will generally last a couple of days to a few weeks, and usually resolves by 6 to 12 weeks.

“When someone is having acute pain, I think it’s appropriate in the first couple of weeks or even one month to follow up with your primary care physician,” says Dr. Powers. “They will help recommend initial options like physical therapy, and maybe some non-opioid medications to help with the acute symptoms.”

If the pain has been persisting for three months or longer, this is usually classified as chronic back pain and also warrants a visit to your provider’s office.

You’re experiencing other symptoms

You should also take note of any accompanying symptoms you may feel in addition to your back pain. You should see your healthcare provider if your back pain is paired with symptoms like:

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  • New loss of sensation or numbness or tingling in an arm or a leg that wasn't there before.
  • New weakness in an arm or a leg that wasn't there before.
  • Loss of control of your bowels or bladder.
  • Difficulty passing stool or inability to control passing stool.
  • A new feeling of numbness that wasn’t there before.

You went through a physical trauma

Another factor to consider is if the back pain started after a specific injury or physical event.

“If you’re having new severe back pain in the setting of any sort of trauma, like a fall or a motor vehicle accident, it's a good idea to see a health care provider so they can perform a thorough exam," Dr. Powers points out. "This way they can further evaluate the pain and any injuries that may have occurred."

“Especially as we get older, we are so much more prone to fractures or malalignment. We want to ensure there was not an acute fracture or change in spinal alignment.”

When should I go to the emergency room for back pain?

Seeing your primary care physician is a good first step if you’re experiencing a flare-up, especially if you notice that your pain is reaching a level where your day-to-day activities are being affected. If your pain is severely impacting your ability to function, you should consider heading to the emergency room instead. 

“If the pain is so severe that you're no longer able to walk or you're having extreme difficulty completing daily activities like moving around your house, making food or showering, a good place to always start is to inform your primary care doctor," suggests Dr. Powers. "Depending on the severity of your symptoms, they may suggest coming to their office for an evaluation, or rather, going to the emergency department."

How is back pain treated?

According to Dr. Powers, your primary care provider will likely approach your back pain with a combination of things like physical therapy, and maybe some non-opioid medications. But this will depend on the source of the back pain and how you’re reacting to specific treatments. 

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In general, we think of three sources of back pain. Pain can be caused by just one of these, or a combination of different pain generators.

  • Muscle pain. “In general, muscle pain tends to feel more like a spasm or an ache.” explains Dr. Powers. This is also the type of pain that your physician will notice is reproducible — in other words, the affected area feels more sensitive when touched or massaged.
  • Joints. “This tends to stay in the back and not radiate into the leg or anywhere else,” points out Dr. Powers. “This kind of pain usually responds well to anti-inflammatory medications like ibuprofen.”
  • Spinal nerve roots. “This is when you’ll experience more of that shooting and radiating pain into the legs. This can be accompanied by numbness, tingling, and sometimes even weakness,” says Dr. Powers.

Once your healthcare provider or specialist has determined what the source of the back pain is, they’ll know how to proceed with treatment options.

“The majority of people will get better in three months with conservative measures like physical therapy and non-opioid pain medication,” Dr. Powers explains. “If the pain is persistent beyond three months, that's when we look at referring a chronic pain physician who can evaluate the pain further, order more advanced imaging if necessary, perform a specialized physical exam, and then consider other options, like injections."

Pain management specialists can offer additional interventions for back pain, such as:

  • Injections to reduce inflammation along a nerve root.
  • Radiofrequency ablation to address pain arising from arthritic spinal joints.
  • Spinal cord stimulators to treat chronic back pain that has not responded to other interventions, including prior back surgery

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