This blog was written by Dr. Alexis Tingan, a physiatrist at the Penn Spine Center. Read  part one of this blog series on some common causes of back pain and how a spine specialist could help treat back pain in this blog series.

Penn Medicine offers an online assessment test to help you learn when it is time to see a doctor for your back and neck pain.

Navigating Back Pain

Have you ever woken up from sleep or came home from a long day at work only to be greeted by sharp pain in your back? Back pain is not a great way to start your day or evening. If you’ve experienced this nuisance, you are not alone.

Approximately 85% of adults will experience back pain at some point. For most people, back pain typically resolves within a few weeks without intervention from a physician or health professional. For the occasional flare up, this is great news.

On the other hand, it is not uncommon to have recurring back pain, which springs up and disappears often. If you or a loved one has experienced the cyclical nature of this debilitating condition, you know it’s better to seek treatment early. Patients should find a treatment plan that will not only serve as a form of pain relief, but one that will address the root cause, eliminating recurrence in the future.

Common Causes of Back Pain

The most common causes of back pain are:

  • Muscle strain which is often caused by damage to the muscles in the lower back including having the muscles overstretched or torn. This is most often caused by heavy lifting, turning, twisting, or sports related injuries.
  • Disc disease which occurs when the discs in the spine begin to degenerate or weaken, causing pain, weakness and numbness in the spine. Disc disease may be caused by genetics, obesity, or a minor injury that causes a herniated disk.
  • Osteoarthritis is the most common form of arthritis and may be caused by genetics, obesity, and/or injury and overuse. Osteoarthritis of the spine may also be caused by a torn disc.
  • Nerve impingement is the result of either a disc compressing a spinal nerve or the spinal nerve canal being narrowed (stenosis). This in turn can cause pain in the spine as well as pain and numbness radiating to the legs.
  • Stenosis which occurs when the open spaces in the lower spine begin to narrow. This causes pressure to be placed on the nerves which can cause pain in the legs and make it difficult to walk.

Without proper treatment, these conditions could be debilitating. If you haven’t seen your primary care physician yet to address your back pain, no need to worry: these conditions often do not require urgent evaluation and treatment.

Red Flag Signs and Symptoms

While you may be quick to dismiss your back pain as something that you can manage on your own or simply “walk off,” there are times when you may need to take immediate action and see a physician. Keep an eye out for these “red flag” symptoms, including:

  • Back pain with fevers and chills, which could indicate an infection in the spine.
  • Night pain with weight loss,  which may be a sign of a spinal tumor.
  • Unsteady gait or bowel/bladder incontinence with back pain, which is a common symptom of a spinal cord issue.
  • Any back pain that begins suddenly after a traumatic event, such as a car accident or fall, which should receive an immediate medical evaluation for fractures, spinal cord injury, or other serious conditions.

Who should you see for back pain?

Depending on your condition, a treatment plan will be made to address your symptoms. Typically, patients are seen by a non-operative specialist first, and are referred to a spine surgeon only if surgery appears to be necessary.

Fortunately, most people with spine pain do not need surgery and will recover with non-operative treatment. However, if surgery is being considered, make sure your provider is an expert in the specific spinal surgery.

Many spine treatment programs, like the Penn Spine Center, include physicians who are specialists in non-operative treatments (like myself), as well as spine surgeons. As a team at Penn, we are able to provide patients with multidisciplinary treatment options.

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