The story of actor Andy Whitfield is a disturbing and educational example of a case that met these conditions — for sure the first two, and probably the third as well if we knew the details. Whitfield was the star of the hit TV show Spartacus (which is worthwhile, but rated very, very R17) The first sign of the cancer that killed him in 2011 was steadily worsening back pain. It’s always hard to diagnose a cancer that starts this way, but Whitfield was in the middle of intense physical training to look the part of history’s most famous gladiator. Back pain didn’t seem unusual at first, and some other symptoms may have been obscured. Weight loss could have even seemed like a training victory at first. It was many long months before he was diagnosed — not until the back pain was severe and constant. A scan finally revealed a large tumour pressing against his spine.
The bottom line is that painkillers always come with risks. Unfortunately, if you consult your conventional physician about your chronic back pain, he will often prescribe a long-term treatment plan that may include anti-inflammatory drugs, muscle relaxants and possibly other types of pain medication or even anti-seizure drugs – a poisonous chemical cocktail that will put your health at severe risk!
Dr. Richard Deyo, one of the great myth busters of low back pain research, believes that “low back pain is second to upper respiratory problems as a symptom-related reason for visits to a physician” — only the common cold causes more complaints. Hart et al puts low back pain in fifth place (lower because Hart oddly excludes chronic low back pain). Chronic low back pain is usually the kind that this book will examine. Andersson writes: “Although the literature is filled with information about the prevalence and incidence of back pain in general, there is less information about chronic back pain ….” Indeed, it is almost impossible to measure how much chronic low back pain there is: for every time that acute low back pain is the main reason for a visit to a physician, how many times does a patient mention low back pain as a secondary problem? Or sees an alternative health care professional about it instead? (Answer: pretty danged often.) So it’s actually possible that low back pain is the single most common reason that people seek help. BACK TO TEXT
But how can you tell? It can be tricky. This is a concise, readable guide to symptoms that need better-safe-than-sorry investigation with your doctor. (It’s basically just a plain English version of clinical guidelines for doctors.9) In other words, this article explains the difference between “dangerous” and “just painful” as clearly as possible. Tables, checklists, and examples ahead.
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Surgery may be useful in those with a herniated disc that is causing significant pain radiating into the leg, significant leg weakness, bladder problems, or loss of bowel control. It may also be useful in those with spinal stenosis. In the absence of these issues, there is no clear evidence of a benefit from surgery.
Another possible cause of chronic back pain in people with otherwise normal scans is central sensitization, where an initial injury or infection causes a longer-lasting state of heightened sensitivity to pain. This persistent state maintains pain even after the initial injury has healed. Treatment of sensitization typically involves low doses of anti-depressants.
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A form of radiculopathy, sciatica causes sharp and burning lower back pain, accompanied by pain through the buttocks and down one leg — Occasionally even reaching the foot. These symptoms occur because the sciatic nerve is compressed and nerve signaling is being interrupted. Vertebral fractures, herniated discs, tumors and cysts may all incite sciatica.
When we are at work, it is common to spend long periods time sitting in a chair. We tend to develop poor posture when we sit and we do a lot of it – at work, watching TV, sitting at a computer, sitting at a child’s sports game or recital, etc. Our bodies learn to hunch and slouch which creates poor posture.
^ Jump up to: a b c Katonis, P.; Kampouroglou, A.; Aggelopoulos, A.; Kakavelakis, K.; Lykoudis, S.; Makrigiannakis, A.; Alpantaki, K. (July 1, 2011). Pregnancy-related low back pain. Hippokratia. 15 (3): 205–210. ISSN 1108-4189.
Feldman M, et al. Sleisenger & Fordtran’s Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management. 9th ed. Philadelphia, Pa.: Saunders Elsevier; 2010. http://www.clinicalkey.com. Accessed Oct. 25, 2014.
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^ Jump up to: a b c d e f g h i j Hoy D, Bain C, Williams G, et al. (June 2012). A systematic review of the global prevalence of low back pain. Arthritis Rheum. 64 (6): 2028–37. doi:10.1002/art.34347. PMID 22231424.
In all other cases, you can safely read this tutorial first. For instance, even if you have severe pain or numbness and tingling down your leg, you can safely read this first. Or, even if you have an obviously severe muscle tear from trying to lift your car or something, you can safely start here — rest and read. Your back is not as fragile as you probably think, and understanding why is a great starting place for healing in nearly all cases of low back pain.