Back pain is one of the most common reasons people seek medical help or miss work, and the biggest predictor of low back pain is simply having had prior episodes of low back pain. The good news is that most back pain is self-limiting and gradually improves within a few weeks with proper treatment and compliance with an appropriate home exercise program.
There are always exceptions to the norms, however, and the following circumstances would be reasons to proceed with caution and/or seek further medical attention when dealing with low back pain (LBP).
Pain/symptoms that spread down one or both legs, especially if the pain goes below the knee.
- Movement of pain out of the legs and towards the spine, called centralization, is a good sign and positions or movements that cause that should be encouraged. Movement of pain further down the legs, peripheralization, is an indication that positions or movements that you are performing should be avoided.
Progressive weakness, numbness, or tingling in one or both legs.
- If your symptoms of weakness, numbness, or tingling do not improve within two weeks, seek further medical attention. Progressive weakness, numbness, or tingling, however, would indicate a more urgent need for further assessment and/or treatment.
Causes new bowel or bladder problems.
- If you experience low back pain that is associated with an acute onset of an inability to void (bladder retention) and fecal (bowel) incontinence, those symptoms indicate a medical emergency, and you should seek medical attention immediately. These symptoms are also usually associated with lower extremity weakness.
Although the above circumstances are not common, it is important to be able to differentiate when to continue conservative care versus when there is a need for further assessment and/or treatment. As physical therapists, we can always help you on your road to recovery. That does not mean that we will always be the one to fix your problem. But if we cannot, it is then our job to help guide you to find the medical provider that can.