How Do I Know When It Is Time To See A Doctor For My Low Back Pain?

With more than 80% of the population experiencing low back pain at some point in their life, the condition can seem not so serious. Ask anyone experiencing an acute or chronic episode, however, and low back pain can feel anything but basic.


Back pain is something that can affect around 80% of the population.

How Long Does Low Back Pain Last?


Low back pain is generally divided into two categories:


  1. Acute low back pain

  2. Chronic low back pain


Acute Low Back Pain


Acute low back pain is defined as pain that has lasted for 6 weeks or less, while chronic low back pain is pain that has lasted for more than 12 weeks. Falling in the middle is subacute low back pain that is defined as lasting 6-12 weeks. Most cases of low back pain fall into the acute category, lasting anywhere from a few days to a few weeks. The good news is that this type of back pain tends to resolve on its own and you can get back to doing all the things you used to do, with no residual loss of function.



Chronic low back pain is defined as lasting for 12 weeks or more.

Chronic Low Back Pain


Chronic low back pain occurs when the pain lasts for 12 weeks or longer. Around 20% of acute low back pain cases become chronic. Those who are affected by chronic low back pain report feeling a constant dull ache, tingling or burning sensations, or sharp stabbing pains. Low back pain varies enormously from person to person and pain sensations can be unique to different individuals.



Many people with acute back pain end up at the emergency room looking for treatment.


How Do I Know If My Back Pain Is Serious?


Fortunately, most cases of low back pain are not serious and the causes are rather benign. But there are some instances where back pain can indicate something more serious that is happening to your body. Because so many people with acute back pain end up at the emergency room looking for treatment, some providers dismiss symptoms or don’t have a complete patient history in order to notice important red flags.


Some healthcare providers will refer to imaging to see if they can pinpoint the cause of the pain, but unfortunately, in around 80% of low back pain cases, a specific diagnosis is not made, and diagnostic imaging is therefore not recommended unless there are specific red flags that are present, along with the pain.



Awareness of red flags can help reduce the incidence of “missed” diagnoses, especially with low back pain.


Red Flags For Low Back Pain


Acute low back pain often has no specific underlying cause and can therefore be hard to diagnose with any type of specificity or certainty. Knowing what signs and symptoms to be on the lookout for can help healthcare providers know when back pain is more benign and when it might be an indicator of something more serious - not just low back pain. Awareness of these red flags can help reduce the incidence of “missed” diagnoses and can help make sure that people get a fast, accurate diagnosis, which can ensure that the right type of treatment is given for the right type of condition.


Red Flags for low back pain include:


  • History of trauma

  • Unexplained weight loss

  • Fever

  • Bladder issues/incontinence

  • A history of cancer

  • A history of steroid use

  • Severe stomach pain

  • Sudden weakness or numbness


Screening all people with low back pain using diagnostic tests like x-rays and MRIs is not cost effective.


How To Diagnose Low Back Pain


When doctors look at low back pain they often use one of 3 different diagnostic methods:


  • Pattern recognition approach (the doctor knows the pattern of injury and pain and can attribute it to something, eg. a fall).

  • Algorithm approach (the doctor follows a specific thought pattern, eventually arriving at a diagnosis via a process of elimination).

  • Red flag approach (specific clues in the patient’s history makes it likely that there might be a more serious underlying condition that needs further investigating and tests).


The Red Flag Approach is helpful for the following reasons:


  1. Screening all people with low back pain using diagnostic tests like x-rays and MRIs is not cost effective - especially since most cases are benign and get better on their own.

  2. Broad screening exposes patients to unnecessary radiation that they don’t actually need or want.

  3. Most cases of low back pain cannot be seen on an x-ray or MRI. Other issues may be present that mislead clinicians to think that those are the cause of the pain when they may have no impact on it at all.

  4. The algorithm approach is often not helpful when trying to make a specific diagnosis regarding low back pain.


If your back pain is persisting it is a good idea to see your primary health care provider.

When To Speak To Your Doctor About Your Low Back Pain


If your low back pain isn’t getting better after a few weeks of gentle exercise and some over the counter pain killers, it is a good idea to make an appointment with your primary care doctor. Seeing your PCP is often more helpful (and less expensive) than heading to the emergency room. Your doctor will know your history and can view your symptoms in the light of any past trauma or illness you may have experienced. They will focus on things like:


  • How long has your pain been going on for?

  • Where exactly are you feeling the pain?

  • Did you experience a fall or an injury that could be the cause of the condition?

  • Are you having any other symptoms that could be linked to it?

  • Your medical history


Taking the time to create a detailed patient history can help differentiate basic low back pain from a serious underlying condition that might need urgent attention. The sooner you can get treatment for anything else the better your health outcomes will be.



Low back pain doesn't have to hold you back.

Conclusions


Knowing what the red flags are around low back pain can help give you an idea of how soon you should see your doctor. Generally speaking, if you have any type of medical history or concern around your lower back, it is better to see your doctor and put your mind at ease rather than waiting until something more serious happens.


Your doctor can look at your medical history and do some basic tests during your appointment to help eliminate some of the key concerns. Hopefully your low back pain will be one of the 80% of cases that are benign and end up disappearing on its own. Low back pain doesn't have to get you down. Know what to look for and when to get help. For more tips on how to help your low back pain go away on itself check out our website.