We tend to worry too much and too quickly when we get low back pain and even more if we are not used to dealing with pain. The reality is that low back pain is rarely a big problem (obviously, you might think differently when you are the one in pain), although can be pretty frustrating. When I say “a big problem” I mean that it isn´t usually dangerous and, therefore, won´t lead to disability.
I do understand that it is not a nice thing to live in pain, I do understand that being unable to play with your kids is a difficult situation, I do understand that you would like to play golf with your friends, but your lower back doesn´t like the idea, I do understand that work can become a bit of a nightmare. We agree on all these things, also, we agree on the fact that not everything we wish in life can be possible (unfortunately). I advise you to be calm and try not to panic, because that is usually one of the reasons that make recovery take longer time.
When you get low back pain and should ask for help right away
I always say to my patients that the only worrying situation when having low back pain are incontinence and/or numbness around the groin area and buttock and suspected spine fracture after an accident. When you present with one of these you should look for medical attention straight away.
Let´s explain this a bit more. You have incontinence when you present with a failure of bowel or bladder control, when you basically don´t decide when to go to the toilet, but it just happens. You have numbness when you present with complete lack of sensitivity to touch, although you might be sensitive to pressure (this being a very strange feeling, as when you go to the dentist). Fractures are very painful, present with inflammation (redness, pain, heat, swelling and loss of function) and you will find that moving is pretty difficult.
When you get low back pain and should think about asking for help
You should be concern about your low back pain when 3 conditions have been met: this pain has been part of your daily life for more than about 6- 7 weeks, it is severe and/or doesn´t improve or even gets worse as the time goes on and one or more of the following “red flags” (signs and symptoms that something is not going well) :
- Low back pain when you are over 55 or under 20.
- Light tapping on the spine is clearly painful.
- Fever without explanation.
- Unexplained weight loss.
- Steroid use, drug abuse and HIV.
- You feel unwell in addition to low back pain.
- You present with indicators of autoimmune disease: family history of autoimmune disease, pain in other joints, uneasy digestion, morning stiffness, among others depending on the disease.
- Symptoms that spread into both legs (equally), especially tingling and/or numbness and/or weakness.
Obviously, the symptoms above-mentioned are also “red flags”: incontinence, numbness around the groin area and suspected fracture.
I am sure you are thinking about cancer, as one of the possibilities when you get severe low back pain and, yes, you are right, it is one of the possibilities, one of the worse possibilities, if not the worse.
As I have told you before, low back pain usually is not a big deal and goes away after some time. Normally, we are who worsen the situation by worrying too much. Stress and worrying are risk factors for low back pain and they can also increase the pain and make recovery slower.
I hope this post helps you to identify situations that should make you think about looking for help and realise that these cases are actually very few.
If you have any questions, do not hesitate to contact me on The Physical Therapy, Physiotherapy Clinic based in Southampton, and I will be happy to help you.