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Spine-Health: Should I See the Doctor for General Back Pain?
Dr. Guyer: In most cases, about 70% of cases of low back pain will get better on their own within just a few days or perhaps a little bit longer. Most of these can be remedied by just resting for a day, taking some over-the-counter anti-inflammatory medications such as Aleve, Advil, or Tylenol, and then the use of ice for the first 48 hours and then heat.
Spine-Health: What pain characteristics should be of concern and make it a good idea to see a doctor?
Dr. Guyer: The warning signals that we worry about with patients with lower back pain are the following. If one has any neurologic deficit such as numbness or weakness or searing pain down the leg, which is more significant. Or, if one is having a problem with bowel or bladder control, which is a more serious problem that can generally lead to surgery.
Spine-Health: What are some of the treatments for back pain besides back surgery?
Dr. Guyer: Well the vast majority of patients never come to surgery. In fact, most patients respond to non-operative treatment. The first treatment we consider is placing a patient on oral anti-inflammatory medications like Aleve, Advil, and Motrin that can be used on a short term basis. We will also have the patient begin an exercise program after a few days of rest to help alleviate lower back pain. Also, chiropractic treatment is also very viable in helping the acute stages of back pain.
Spine-Health: Do you ever give patients injections or something like that?
Dr. Guyer: Patients will respond to injections if they have signs of unremitting back pain. This includes having at least an MRI scan to determine if any other factors such as intra-abdominal problems such as issues with the blood vessels, an infection, or even a tumor are causing such pain. Once we are certain that no other serious problems are causing the lower back pain, injections then become a viable option. If it's back pain alone, facet injections into the little joints of the back can be helpful. If it's a disk problem that’s putting pressure on a nerve, an epidural or a selective nerve block may be helpful for the patient.
Spine-Health: The bottom line is that most lower back pain symptoms will go away on their own in 2-3 weeks without requiring a visit to a doctor. If you do continue to have pain after that they should seek out a doctor, correct?
Dr. Guyer: That is correct. I recommend seeing a physical therapist first to be instructed on proper exercises, stretches, and additional core strengthening exercises that can help alleviate back pain. These exercises can also include Yoga or Pilates. If you are still in pain after you begin following the exercises provided by the physical therapist, then I recommend the patient seek out a back doctor.