What to know about sharp lower back pain

From medicalnewstoday.com

Sharp lower back pain is a common source of discomfort for many people. It can cause concern to some people, especially when it appears without a known cause

Lower back pain is a widespread problem. About 80 percent of adults will experience lower back pain at some point.

In most cases, people develop back pain after doing something strenuous, such as lifting a heavy box, weightlifting, or making a quick twisting or jerking motion involving the back.

The level of the injury and the severity of the pain may affect the type of treatment a person needs. Sometimes, minor cases of sharp lower back resolve by themselves, but some people may require a visit to the doctor and physical therapy to help strengthen the muscles and prevent future injury.

Keep reading to learn more about some different causes of sharp lower back pain and how to treat them.

Causes

Many different muscles, bones, and connective tissues meet in the back. This means that individuals may experience a wide variety of symptoms in the lower back. Small variations in the way a person experiences pain may help a doctor identify the source of the pain.

Muscle strains

A muscle strain might happen as the result of a simple action, such as bending down to pick something up or twisting while holding something heavy.

A person may experience a sharp pain that causes a burning or tingling sensation or a radiating ache. They may also feel they have a stiff back, aching muscles, and pain that gets worse if they twist or move the back.

Muscle strains are generally minor injuries and often require little or no treatment.

However, these types of injury generally respond well to rest, which means avoiding physical activity for a few days while the muscles heal. While a muscle strain is healing, avoid sitting in an upright position, such as at the desk, as this may engage the injured muscles.

However, after a few days of rest, physical activity can help strengthen the muscles. A review in Asian Sine Journal notes that both general exercise and exercises specific to the back can help reduce lower back pain. Gentle activities, such as swimming or riding a bike, may help strengthen the muscles and keep the body healthy.

Also, working with a physical therapist to create a gentle workout routine can help strengthen the affected muscles in the back.

Hot or cold packs may help treat symptoms such as swelling and pain. Alternate between 20 minutes of cold and 20 minutes of rest a few times each day for the first few days. Afterward, using a heat pack may help relax the tense muscles and promote circulation.

Over-the-counter (OTC) pain relievers, such as ibuprofen (Advil) or acetaminophen (Tylenol), may also help control symptoms. However, always follow the dosage recommendations and do not use them to work through the pain.

Sciatica

The sciatic nerve is a long nerve that runs from the back to the legs. Sciatica, which refers to pain in this nerve, occurs due to pressure on the sciatic nerve. This pressure can be due to an injury, such as a herniated disc, or more long-term issues, such as incorrect posture.

Sciatica is relatively common in adults, with between 10-40% of people experiencing it at some point during their lives. It is important not to generalize back pain or assume that any lower back pain is sciatica. Anyone who suspects they have sciatica should see a doctor.

Pain from sciatica may build up over time or come on all at once. It can also vary between a dull ache and an excruciating tearing or burning feeling.
Many describe the pain as warm or sharp, and it typically radiates from one side of the lower back down to the hip or buttocks.

Working with a physical therapist to help strengthen the back muscles might help alleviate pain from sciatica. Practicing proper posture, especially while seated, might gradually strengthen the back and prevent extra pressure on the nerve as well.

Intervertebral disk degeneration

As a person ages, the structures in the body age with them. The rubbery disks that cushion the spine can begin to wear down, often causing pain and stiffness in the back.

Some OTC anti-inflammatory medications and workouts may help relieve pressure on the disks.

Herniated disk

A slipped, or herniated, disk occurs when one of the spinal disks ruptures. This can put pressure on the nerves, which causes intense, sharp pain.

If the disk puts pressure on these nerves, a person might experience symptoms such as:

• tingling pain or numbness in the lower back, buttocks, and legs
• muscle spasms
• weakness in the lower back and legs

Most cases respond well to mild treatment, such as rest and physical therapy. Surgery may be an option in more severe cases.

Serious injury from accidents

Forceful injuries from impact sports, car accidents, and falls may all cause sudden back pain. Anyone who experiences back pain after such an event should visit the doctor right away because the pain might be a sign of something more serious, such as a fractured bone in the back.
Other signs of serious injury in the back can include:

• loss of bladder control
• numbness in the groin or pelvis
• weakness in the legs
• pain when coughing or urinating

Anyone experiencing these symptoms should see a doctor.

Other chronic issues

Pain in the lower back may be due to an injury but may also be a sign of a chronic issue, such as:

• poor posture
• scoliosis
• spinal stenosis
• spondylitis
• kidney infection
• kidney stones
• arthritis
• fibromyalgia
• infection of the spine
• spinal cancer

In females, lower back pain might signal a range of conditions, such as ovarian cysts, uterine fibroids, or ovarian cancer.

Situational causes

Back pain is widespread, and most people will experience some form of back pain from a muscle strain at least once in their lives. Back pain may occur due to a variety of seemingly everyday activities or situations, such as:

• lifting a heavy box
• moving furniture
• lifting heavy weights at the gym
• overstretching
• twisting while practicing sports such as tennis or golf
• engaging in physical contact sports
• twisting the back incorrectly while carrying weight
• carrying extra weight from pregnancy
• physical labour, such as agricultural or construction work
• sitting or standing for long periods
• wearing a purse, bag, or backpack over one shoulder

When to see a doctor

Sometimes, a person will know the cause of a sharp lower back pain. It may happen after they bend to pick something up or after an intense workout at the gym. In these cases, rest and home care may be enough to help the body heal.
There are some occasions when a person should see a doctor.
See a doctor if the pain does not respond well to home treatments or if a pain that has no known cause lasts more than a couple days.

Troubling symptoms, such as tingling or weakness in the legs, are signs to visit the doctor, as well.
Take note of any symptoms as they appear to share with the doctor. During the visit, the doctor will likely ask the person to describe their symptoms and how long they have persisted.
They may ask the person to do a series of movements to try and find the exact point of pain in the back and determine the underlying cause.
They may also order imaging tests to help with the diagnosis in some cases, such as X-rays or MRI.

Summary

Experiencing lower back pain is widespread. It often results from incorrect lifting or putting too much strain on the muscles in the back. Some chronic conditions may lead to back pain, as well.
Back pain from more minor injuries and strains generally responds well to home treatments, such as OTC pain relievers, ice, and rest.

Strengthening the muscles with physical therapy may help prevent strain injuries in the future. If the pain does not begin to get better within a few days, it may be time to see a doctor for a full diagnosis.

In each case, working directly with a doctor or physical therapist can help identify and treat the underlying cause of sharp back pain in most people.

https://www.medicalnewstoday.com/articles/327131.php#summary

Back Pains? Get down on your hands and knees

From pattayamail.com

By Dr. Iain Corness

One of the commonest ailments to result in a GP consultation is low back pain. The cause of this is locked in the history of the development of mankind. You see, when we walked on all fours, we didn’t get low back pains at all, because our spines were designed to be horizontal and weight was carried on the back, just like a horse does today. The design of the vertebrae is such that the spine in the horizontal position ‘locks’ to be able to weight bear.

Now, here’s where it all went wrong. We decided we looked much better standing upright and we could walk much quicker using our hind legs only. This meant that our spine was now vertical and we could bend it backwards and forwards. Backwards and the bones all locked together again, but forwards and the vertebrae unlock making the spine unstable.

The next factor was we began to try and lift weights in this new upright position. We bent forwards (unstable) and lifted items like that. The era of low back pains had arrived.
Many generations development of our ancestor (called Homo erectus) kept that low back weakness and we are now Homo sapiens, older but not much wiser. Our spines are still weak. Our lumbar discs cause pain.

Many years ago I was a surgical assistant to a spinal surgeon, and the best description of the surgery was operating at the bottom of a red inkwell. Fortunately modern technology has made removal of a disc an operation that can be carried out as a minimally invasive procedure.

Let’s begin then with the “slipped disc” problem. First thing – discs do not “slip”. They do not shoot out of the spaces between the vertebrae and produce pain that way. The disc actually stays exactly where it is, but the centre of the disc (called the nucleus) pops out forwards through the edge of the disc and hits the nerve root. When this happens you have a very painful condition, as anyone who has had a disc prolapse will tell you. Think of the pain when the dentist starts drilling close to the tiny nerve in your tooth. Well, the sciatic nerve is a large nerve! When the nucleus of the disc hits the sciatic nerve, this produces the condition known as Sciatica – an acute searing pain which can run from the buttocks, down the legs, even all the way through to the toes.

To accurately work out just what is happening requires bringing in specialist doctors who can carry out extremely intricate forms of X-Rays called CT Scans, Spiral CT’s or MRI that will sort out whether it is a disc prolapse, arthritis or another soft tissue problem. The equipment to do these procedures costs millions of baht, and the expertise to use them takes years of practice and experience. This is one reason why some of these investigations can be expensive.

After the definitive diagnosis of your back condition has been made, then appropriate treatment can be instituted. The forms of treatment can be just simply rest and some analgesics (pain killers), physiotherapy, operative intervention or anti-inflammatories and traction.

It is important to find the real cause for your aching back, as well as standing erect. The treatment for some causes can be the wrong form of therapy for some of the other causes. You can see the danger of “self diagnosis” here. Beware!

So what do you do when you get a painful back? Rest and paracetamol is a safe way to begin. If it settles quickly, then just be a little careful with lifting and twisting for a couple of weeks and get on with your life as normal. Might even be a good idea to miss the next couple of golf games. If, however, you are still in trouble after a couple of days rest, then it is time to see your doctor and get that definitive diagnosis. You have been warned!

There is a Spinal Minimally Invasive surgeon in my hospital. One of my colleagues at Bangkok Hospital Pattaya has just had that procedure and was walking pain-free the next day and ran a marathon the week later.

https://www.pattayamail.com/modernmedicine/back-pains-get-down-on-your-hands-and-knees-2-275935