When Back Pain Is Serious: How To Tell, What To Do

Most adults will experience back pain at some point. One of the most common medical complaints is lower back pain.

Typically, back pain is muscular in nature and short-term, often caused by strain from lifting heavy objects or sudden movement, says UH orthopedic specialist Zachary Gordon, MD. More serious back and spine problems may be caused by nerves, joints and discs, he says.

Most back pain will resolve on its own within a few weeks. Home care, including over-the-counter pain relievers, heat, ice and rest can help. If back pain doesn’t subside and is disrupting daily activities or sleep, you should see a doctor. A primary care physician may help in cases where pain is caused by strain or mild injury.

When It’s Severe Pain

If your pain is severe and ongoing, it’s time to see a specialist such as an orthopedist or a physical medicine and rehabilitation doctor, which is sometimes called a physiatrist, Dr. Gordon says.

An orthopedist is a surgeon who is devoted to the prevention, diagnosis and surgical and non-surgical treatment of disorders of the musculoskeletal system – your bones, joints, ligaments, tendons and muscles.

Some orthopedists are generalists, while others specialize in certain areas of the body such as hip and knee, foot and ankle or shoulder and elbow, Dr. Gordon says.

A physiatrist is a medical doctor who has completed training in the specialty of physical medicine and rehabilitation and may be subspecialty certified in other areas, such as brain injury medicine, neuromuscular medicine or sports medicine.

Physiatrists focus treatment on function and treat the whole person, not just the problem area. They have broad medical expertise that allows them to treat disabling conditions throughout a person’s lifetime.

Causes of Severe Back Pain

Though muscular strain is the most common cause of back pain, there are many possible causes, Dr. Gordon says, including:

• Arthritis
• Compression Fractures due to osteoporosis (bone degeneration)
• Fractured vertebrae
• Herniated disc (sometimes called a slipped disc) or degenerative disc disease
• Osteomyelitis (bone infection)
• Sciatica (nerve pain)
• Stenosis (narrowing of spaces within the spine)
• Scoliosis (spinal deformity)
• Spondylolisthesis (vertebrae shift)
• Spinal cord tumor

Watch for these symptoms that warrant medical attention: pain accompanied by numbness or tingling in the arms or legs; back swelling and redness (which could indicate infection), bowel or bladder problems or unintended weight loss, Dr. Gordon says.

Also, seek medical care if pain radiates down one or both legs, he says.

To determine the cause of chronic back pain, your doctor may order tests such as X-ray, magnetic resonance imaging (MRI), computed tomography (CT) scan, bone scan or electromyography, which is a test to diagnose neuromuscular abnormalities.

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For all ages and levels of care, University Hospitals’ highly skilled and experienced orthopedists and fellowship-trained surgeons care for the full spectrum of adult and children’s muscle and skeletal conditions, including sports injuries and every area of orthopedic specialty care. Learn more about orthopedic services at University Hospitals.