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Meanwhile, it’s extremely common for non-life-threatening low back pain to be alarmingly severe and persistent — to have a loud bark! Your doctor may not appreciate how true this is, and may over-react to all persistent low back pain, even without other red flags. In most cases, you shouldn’t let them scare you. Being “freaked out” about persistent back pain is the real threat: it can make low back pain much worse, and much more likely to last even longer (a tragic irony).
Sifters The physical examination focuses on the spine and on evaluation of the nerves to the groin and legs to look for signs of nerve root compression. Signs of nerve root compression depend on which nerve roots are involved and include weakness of one of the muscle groups in a leg, abnormal reflexes (tested by tapping the tendons below the knee and behind the ankle), decreased sensation in an area of the leg, and, very rarely, retention of urine, and incontinence of urine or stool (fecal incontinence).
Ben-Ami N, Chodick G, Mirovsky Y, Pincus T, Shapiro Y. Increasing Recreational Physical Activity in Patients With Chronic Low Back Pain: A Pragmatic Controlled Clinical Trial. J Orthop Sports Phys Ther. 2017 Feb. 47 (2):57-66. [Medline].
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You do need physical activity Exercise can also help people maintain a desirable weight. Weight-bearing exercise can help people maintain bone density. Thus, exercise may reduce the risk of developing two conditions that can lead to low back pain—obesity and osteoporosis.
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Mom was right when she said, “Stand up straight!” Your back supports weight best when you don’t slouch. This means sitting with good lumbar support for your lower back, shoulders back, with feet resting on a low stool. When standing, keep weight evenly balanced on both feet.
Health A-Z Patients generally present with a history of an inciting event that produced immediate low back pain. The most commonly reported histories include the following:
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Diagnosis is made by a neurosurgeon based on history, symptoms, a physical examination and the results of diagnostic studies, if necessary. Some patients may be treated conservatively and then undergo imaging studies if medication and physical therapy are ineffective. These tests may include:
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New York Yankees $22.43 Opioid analgesics: These drugs are considered an option for pain control in acute back pain. The use of these medications is associated with serious side effects, including dependence, sedation, decreased reaction time, nausea, and clouded judgment. One of the most troublesome side effects is constipation. This occurs in a large percentage of people taking this type of medication for more than a few days. A few studies support their short-term use for temporary pain relief. Their use, however, does not speed recovery.
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Plain X-rays are generally not considered useful in the evaluation of acute back pain, particularly in the first 30 days. In the absence of red flags, their use is discouraged. Their use is indicated if there is significant trauma, mild trauma in those older than 50 years of age, people with osteoporosis, and those with prolonged steroid use. Do not expect an X-ray to be taken.
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