My back aches. Should I see my doctor?
Back and neck pain are common ailments and a top reason people visit their primary care doctor. One study by the Centers for Disease Control and Prevention (CDC) showed that low back pain specifically was reported in a quarter of U.S. adults and causes disability more than any other condition. Bayhealth Neurosurgeon Amit Goyal, MD, explained factors that often contribute to back and neck pain, steps that can help, how to identify a serious condition, and when it’s time to see your physician.
Dr. Goyal said for many adults, back and neck pain is associated with arthritis in the spine joints or in the muscles of the neck or lower back. Being overweight or obese is a significant risk factor for low back pain. “A lot of people think their pain might be a nerve issue, but it’s usually the muscles being affected. Constantly supporting our head and our torso, muscles around the neck and spine have a lot of tension and can easily fatigue. Excessive weight, particularly in the abdomen, can put further strain on back muscles.”
With back or neck pain, a couple general factors should be considered, such as body mass index (BMI) and how long the pain has gone on, explained Dr. Goyal. If a person has a high BMI, he advises trying to lose weight first to see if their condition improves. “For individuals who are more than 100 pounds overweight, I often recommend a bariatric surgery consult — I’ve had patients who have the surgery and lose the weight, and their back gets better. For those with less to lose, I encourage working towards lifestyle changes — eating better and being more active, such as walking for half an hour a day for three days a week. Many times they’ll notice as the weight gradually falls off, their back pain goes away.”
If back or neck pain is ongoing and hasn’t improved after six weeks, that’s typically the point when a primary care doctor will refer a patient to a specialist. In the meantime, common treatment measures, such as applying ice or heat to the muscles, using over-the-counter anti-inflammatories and ceasing the activity or motion that brought the pain on initially, can help. “It may sound obvious, but you need to give your body a break from the particular action that triggered the pain, and let the muscles heal,” said Dr. Goyal. “You can still be active if you can tolerate other types of movement. If you have shooting pain that goes down the back to the extremities, have numbness or weakness, cannot walk at all, or experience incontinence, these are red flags indicating you should see a doctor.”
Dr. Goyal emphasized that if you’re referred to a specialist for back or neck pain, it’s important to have an MRI done beforehand. This will allow the physician to see if there are any abnormalities on the scan that match up with symptoms. If an MRI result is normal, a patient may still be a candidate for physical therapy, injections or chiropractic treatment as other ways to find pain relief.
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