When to get help for low back pain

low back pain

Low back pain (LBP) is common, with 80% of adults likely to experience it in their lifetime. This group includes individuals from their early twenties and continues throughout adulthood. Factors such as prolonged sitting, sedentary jobs, falls, highly physical jobs, cigarette smoking, obesity, and extreme tallness increase the risk of experiencing low back pain

Lower back pain is mainly triggered by an injury like muscle sprains or strains. Poor body mechanics, especially when lifting heavy objects, can also injure your lower back or lumbar spine. 

Many times, this pain is self-limiting. Within a few days or weeks of self-care, your back pain can be relieved. The common home remedies known to reduce lower back pain include the following: 

  • Rest
    As you rest, it would help if you avoid heavy lifting or aggravating tasks like prolonged sitting, bending, or driving. 
  • NSAIDs or painkillers
    A physician can prescribe common anti-inflammatory drugs like ibuprofen and aspirin to alleviate your back pain.
  • Ice
    You can apply ice to the lower region of your back for 15 minutes every 1-2 hours. Using ice will reduce pain and muscle spasms.
  • Positioning
    Changing your sleeping position can help ease the strain on your lower back. Ensure that your bed is firm enough to give proper support and use a small pillow for your head. 
  • Early exercise
    Gently exercising for stretching and mobility of the back and leg muscles can reduce the duration, intensity, and relapse of the pain.

When at-home remedies do not work 

However, lower back pain symptoms can vary in individuals. They can range from a dull ache to a sharp and stabbing pain. You can also experience constant pain or one that is intermittent and positional. 

Although acute back pain usually lasts several days to a few weeks, chronic back pain persists for over three months. How will you know when you should stop the at-home remedies and seek help? 

Prolonged pain

Generally, you should consult a physician if you have prolonged back pain longer than 72 hours as the pain may point to a more serious issue. A health professional will identify the source of the pain and provide medical tips to manage the pain. Aside from strains from physical activity, other causes of LBP that can be identified include:

  • Disc injury
    The discs that make up the lower back are likely to get injured. The outer portion of the disc can herniate or tear. The risk of this injury increases with the advancement in age. A herniated disc constricts the nerve root as it leaves the spinal cord and goes through the vertebral bones, causing pain. 
  • Sciatica
    Sciatica occurs when the herniated disc puts pressure on the sciatic nerve, which runs from the spinal cord to the legs. This pressure causes pain in the legs and feet. This pain has been described as feeling like pins and needles or burning. 
  • Abnormal spinal curvatures
    The abnormal curvature of the spine may be caused by congenital conditions like lordosis, scoliosis, and kyphosis. This curving of the spine puts pressure on muscles, ligature, tendons, and vertebrae, causing pain and a poor posture. 
  • Spinal stenosis
    Spinal stenosis occurs when the spinal column tapers and constricts the spinal cord and nerves. This condition commonly happens when the discs located in the middle of the vertebrae degenerate. This condition causes the compression of either the nerve roots or the spinal cord by soft tissues or bony spurs. This burden on the spinal nerves causes numbness, weakness, and cramping.
  • Other health conditions
    Conditions like kidney and bladder infections, endometriosis, cancer, ovarian cysts, uterine fibroids, arthritis, fibromyalgia, spondylitis, and spondylosis have also been cited as causes for low back pain.

Help for Lower Back Pain

As a patient suffering from low back pain, physical therapy will be your first treatment option. This option is more conservative than other forms of treatment, like back surgery and spinal injections (https://www.health.harvard.edu/pain/when-to-get-help-for-low-back-pain). Physiotherapy aims to decrease back pain, increase function, and teach the patient a maintenance program to prevent future back problems. 

Physiotherapists in Singapore work closely with medical teams to ensure that patients get back to their original physical state through several treatment options. When you first go to a physiotherapist, they will need to learn your medical history. This information will include any medical conditions you have, any medications you take, and your lifestyle. 

Techniques used by physiotherapists as help for low back pain include:

  • Therapeutic exercises
    Exercises involve the patient executing movements that have been prescribed to correct impairments and restore muscular and skeletal functions. These include stretching exercises, aerobic exercises, and strengthening exercises. These exercises may reduce the duration, severity, and recurrence of low back pain. 
  • Manual therapy
    When your physiotherapist does manual examination and identifies abnormalities in your muscles and joints, specific manual therapy techniques can be used to reset the muscle tension and joint position. This physiotherapy treatment greatly reduces lower back pain symptoms, and makes it easier for you to perform exercises in the right way.
  • Thermotherapy/ Heat therapy
    Thermotherapy relies on the use of heat in therapy for pain relief and health. This heat can be applied using hot cloths, hot water bottles, whirlpool baths, heating pads, and others. The application of such treatments may relieve pain, increase vasodilation and blood flow, and relax muscle spasms. 
  • Electrical stimulation
    The electrical impulses employed can reduce the pain signals traveling from the spinal cord to the brain, which may relieve the pain and relax muscles and may provide help for low back pain. 
  • Ultrasound therapy
    This form of therapy uses vibration to deliver heat and energy into the lower back. This treatment is applied to spinal muscles, tendons, ligaments, and bones. Ultrasound therapy may reduce pain and speed up healing.

Reporting Immediately to a Doctor 

In some cases, other factors will accompany your low back pain. These will make your situation a medical emergency that needs the expertise of a doctor. Such factors you need to consider include:

  • Trauma
    In case you recently experienced serious trauma, you should immediately consult a doctor. A car accident or a fall from a great height could be damaging to your lower back and causing the pain.
  • Certain symptoms
    If you are also experiencing fever, bowel or urinary incontinence, severe abdominal pain, altered or loss of sensation in the groin/legs, weakness, or weight loss, you should see a doctor to find help for low back pain. 

In conclusion, you are likely to experience lower back pain in your lifetime. Using the listed self-care remedies like rest and exercise is likely to relieve this pain. However, if the pain persists for over 72 hours, it is advisable to seek help. Here, treatments such as physiotherapy, or further tests will be recommended to determine the cause of your back pain.