If your back is bothering you, you may wonder whether you should see the doctor.
Unlike an ankle or a wrist that swells, you often can’t see anything wrong with your back. How do you tell the difference between run-of-the-mill back pain and a more serious injury?
If you have intolerable, radiating pain that makes it impossible to use the bathroom, that’s a red flag. So is loss of sensation around your groin. Call your doctor immediately for these symptoms.
But otherwise, how do you know when to see a doctor for back pain?
What’s the Difference Between Acute vs. Chronic Back Pain?
Acute back pain comes on quickly. It’s usually tied to an event — a way you moved or something that happened.
This could include sudden moves like bending, twisting, or lifting something heavy. You might also have acute back pain after a car accident or an on-the-job accident.
Acute back pain can last from a few days to a few weeks. You may have lower right back pain, lower left back pain, or pain in the center. Unless it’s a severe injury, there’s a good chance it’ll go away on its own.
By contrast, chronic back pain is pain that lasts for more than three months. Chronic pain is less likely to go away on its own.
If you’ve been in steady pain for three months or more, it’s definitely time to see the doctor.
But there are other reasons you might also want to see a doctor. It depends on what has caused your back pain.
Why Does My Lower Back Hurt?
Your spine is a complex structure, with many moving parts and things that can go wrong. But there are a few common types of problems and injuries. (Note that your back pain might have links to several of these causes.)
Sprain or strain from overuse
If you overstretch or injure a ligament, you may have a mild back sprain. If you overstretch or injure a muscle, it can cause a mild back strain. Though these injuries are mild, they can cause intense pain for a few days.
Wear and tear
Officially called degenerative disc disease, it means that the disks in your back are wearing out. Just like knee cartilage can wear away with time, age, and overuse, so can the disks that cushion your spine. You can also have osteoarthritis in the joints between your spine.
By a certain age, most people have some degree of disc disease. If your discs are very worn out, they can cause pain on and off.
Disc injuries
You can also injure one of your discs. You can tear it, or you can develop a herniated disk. A herniated disc means the jelly-like center of the disk is pushing outward, making the disk “bulge.”
It can press on nerves if it bulges too much (a bulging disc). This can cause pain down your leg (often called sciatica). It can also lead to numbness and tingling down your leg, even into your foot.
Narrowing of the spine
When the space around your spinal cord gets narrower, it can put pressure on your nerves, a condition called spinal stenosis that can happen with age. Having osteoarthritis in your discs can also lead to stenosis.
What Kinds of Symptoms Should I Worry About?
You might have stabbing, shooting, or aching pain.
Though it’s not exactly “normal” to have this pain, as long as it continues to improve, you should find you can treat it at home. (See below to learn more about treatment options.)
You should think about making an appointment to see your primary care doctor or an orthopaedic doctor if:
- You have a fever, loss of appetite, or other symptoms that let you know something isn’t right.
- You have issues with your bowels, such as loss of control or an inability to poop. (Seek care for this immediately .)
- You have new numbness, tingling, or weakness in your arms or legs.
- Your pain is worsening or not improving at all after three days.
- You’ve had a trauma or an injury (like an accident or a fall).
What Will Happen at the Doctor’s Office?
Your doctor will take a medical history and ask you to describe your symptoms.
To examine you, they may press on different areas along your spine. They may move your back in different ways, asking about your pain. They’ll check your reflexes with a small rubber hammer and check for any concerning muscle weakness.
They’ll ask you to sit, stand, and walk. They may ask you to bend in all directions and lift your legs straight up while lying down.
Depending on what they suspect, they may order an x-ray. An x-ray can see some things (like fractures) but not others. Seeing soft tissue issues on an x-ray is often difficult.
Your doctor might suggest you get an MRI so they can see any damage more clearly. But they don’t usually suggest this unless they suspect an injury.
How Do Doctors Treat Back Pain?
For most people, doctors start with the most conservative treatment. Lots of people can get better by taking over-the-counter medicine and going to physical therapy.
A physical therapist can work with you to identify what muscles to target to help improve your pain. They’ll give you an exercise and stretching plan.
If your pain doesn’t get better with exercise and therapy, your doctor might suggest pain relief injections. You can also try other therapies, like acupuncture and chiropractic care.
If your pain persists and is keeping you from doing what you love, your doctor may suggest a surgical procedure. There are many minimally invasive surgeries that orthopaedic surgeons can do these days.
How Can I Treat My Back Pain at Home?
Home treatment involves rest but not bed rest. In fact, staying in bed can make back pain far worse. Though you don’t want to move in ways that aggravate the pain, you should move as you’re able.
Some other things you can try at home:
- Ice the painful area for the first two to three days, then use a heating pad.
- Put a pillow between your legs if you sleep on your side to relieve pressure on your back. If you sleep on your back, put a pillow under your knees.
- Take over-the-counter medicine to help with pain and inflammation. This includes ibuprofen (Advil), naproxen (Aleve), or acetaminophen (Tylenol).
Editor's Note: This article was originally published on , and was last reviewed on .