Dr. Roger Hicks
If you suffer from back pain, you are not alone. Low back pain is one of the most common reasons Americans visit their health care provider, a fact that I see played out every day at Yubadocs Urgent Care clinic.
Almost 9 of 10 adults have back pain at some point in their lives, and it can be scary. The good news is the pain usually goes away on its own, most people recover in a week or two, and there are many things you can do to prevent low back problems.
There are many possible causes of low back pain, but strained back muscles, tendons and/or ligaments is the cause more than 85% of the time. This often is caused by doing too much for too long without enough conditioning or stretching.
It can also happen because of improper lifting. To avoid injury, be sure to lift with your legs, not your back, and get help if what you need to lift is heavy. Avoid carrying heavy bags including backpacks and purses unless they are centered properly along the spine.
There are several lifestyle factors that increase your risk of having back problems. Smoking is one. Research shows smoking can slow down circulation and reduce the flow of nutrients to joints and muscles, including in your back. Being overweight is another. Suppose you are 30 pounds over your ideal weight. Now imagine that 30 pounds is a backpack. Think of what carrying around a 30-pound pack 24 hours a day would do to your back. Excess weight in the stomach is worse because it pulls the pelvis and lumbar spine forward, straining the lower back. Not smoking and dropping extra pounds and are important for overall health, including your back.
Although most low back pain goes away on its own, professional help is sometimes needed. There are red-flag warnings for when a doctor visit is needed. You should be seen if you recently had a fall or injury to your back, if you have numbness or weakness in your leg or foot, or pain or numbness in your buttocks or genitals. Other reasons include unexplained weight loss, a fever or feeling sick in other ways, or if you have cancer, osteoporosis or a weakened immune system. See a doctor urgently or go to the emergency department if you lose control of your bladder or bowels.
A visit to an urgent care facility or to your regular doctor is in order for pain that gets worse, instead of better over time.
A good medical history and physical exam are usually all that is needed to evaluate back pain present for less than a month. Less than 1% of people seen in in their doctor’s office or an urgent care center for low back pain need immediate advanced imaging (CT or MRI). Unless one of the red-flag warnings outlined above is present, results from these tests do not change initial treatment and may complicate things by revealing what are called “incidental findings” – anatomic variations not necessarily causing pain that are found in people with no symptoms that can lead to further unnecessary tests or treatment.
What can you do for low back pain? First, maintain your normal level of activity as much as possible. Bedrest used to be the standard advice, but studies have shown that it not only doesn’t help, but it can delay recovery. So, stay active.
Put heat on your back for 20 minutes every 2-3 hours and follow it with gentle stretching. Cold packs on the same schedule relieve pain for some, so use them if you find they help.
Sleeping on a comfortable mattress can be a game changer when it comes to back pain. If you sleep on your side, draw your knees up slightly and put a pillow between them. If you sleep on your back, putting a pillow under your knees will help maintain the normal curve of your lower back and take some strain off your spine.
Exercise is often recommended for low back pain because it reduces pain and helps maintain or restore flexibility, strength and endurance. It doesn’t seem to make much difference in preventing or curing short episodes of low back pain, but many studies have shown that it helps when pain has been present more than a month. It also helps prevent chronic back pain, which is back pain present continuously for more than three months.
What kind of exercise? Examples of exercise programs that are known to be beneficial include walking, aerobic exercise, swimming, stretching, Pilates or other core strengthening, and exercises with a mind-body component like yoga or Tai Chi. As with any movement-based activity, injuries and other adverse events occur with exercise. So, consult with your health care professional and choose exercises you enjoy.
Fortunately, most all people’s low back pain will be gone within a few weeks. If it lasts longer, it is time for a visit to you doctor or your local urgent care center.
A director of the Urgent Care Association of America from 2011 to 2017,
Dr. Roger Hicks served as the Association’s treasurer and then secretary. He is a founder and current board member of the Urgent Care Assurance Company, a malpractice company specializing in urgent care. He is the founding President of the California Urgent Care Association. He is also the founding president of the South Yuba River Citizens League and served on SYRCL’s Board of Directors for 30 years