Back pain: is it really a medical emergency?

By Cristiano Antonino On Feb 6, 2023

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Did you know that back pain is one of the most common reasons why people go to the emergency room? This common ailment is experienced by about 80 per cent of adults at some point in their lives

The intensity of back pain can vary from dull and painful to sudden and acute.

Today we discuss the risks, causes and treatments of back pain.

Causes of back pain

Some people are born with pain, while others develop back pain throughout their lives.

Several factors are generally attributed to back problems.

Despite all these causes, more than 80 per cent of known cases have unidentified causes.

Causes of back pain can be as follows:

Sciatica – Pain that starts at the hip and buttocks and continues down the entire leg. Sciatica indicates that the sciatic nerve is the cause of pain in this condition.
Herniated or ruptured disc – Also known as a ‘bulge’, ‘rupture’ or ‘tear’, a herniated disc occurs when the disc leaks through the outer layer of ligaments surrounding it. Between each vertebra of the spine are spinal nerves that branch from the spinal cord to a specific area of the body. If a disc protrudes over a spinal nerve, the pain can potentially spread to the area of the body served by that nerve. It is very common for a ruptured disc to occur when a person is between the ages of 30 and 40.
Scoliosis – Studies show that there are several causes of scoliosis, such as congenital spinal deformities, genetic conditions and/or osteoporosis. Adults can also develop scoliosis due to age-related wear and tear. Despite the extensive list of causes, 80% of scoliosis cases have no known cause.
Strains and sprains – Due to a hard day’s work, sudden movements or physical activity, pain or injury can often result from a strain or sprain of muscles and ligaments. Back strains or sprains are associated with activities such as bending, twisting and lifting heavy objects. Keep in mind that a strain is the tearing or overstretching of a ligament, while sprains are tears of tendons or muscles.

Risk factors for back pain

According to the National Institute of Neurological Disorders and Strokes (NIH), several risks can be the cause of our daily back problems.

These factors may include

Age – It is common for older adults to be more susceptible to back pain than younger adults or children. Generally, adults between the ages of 30 and 50 regularly suffer from back pain. With advancing age, osteoporosis – the loss of bone strength – leads to fractures, loss of muscle elasticity and decreased tone.
Mental health factors – It is known that mental illnesses such as anxiety or depression increase the likelihood of suffering from back pain. Whether they are pre-existing conditions or develop as a result of chronic back pain, these psychological factors may be the main culprits.
Weight gain – The more overweight one is, the greater the risk of developing back pain and other disorders. Rapid weight gain can increase the risk of back pain simply because the body is trying to balance the weight and pressure exerted on the back.
Level of physical fitness – Working all day at a desk can also increase the risk of back pain. It is helpful to focus on straightening your posture when sitting or standing. Ideally, one should be able to sit upright in a chair with support in the lower back. For keyboard users, it is good to keep the elbows at a right angle and the forearms horizontal.
Pregnancy – For many women, back pain during pregnancy is common due to pelvic changes and weight. The symptoms almost always resolve after delivery.

How to tell if it is a real emergency

Although back pain is common, sometimes home treatments may not be sufficient.

If you experience one or more of the following conditions, you should seek medical attention immediately:

fever
Weight loss
Back swelling
Constant back pain – rest does not help
Pain in the legs and under the knees
Involuntary urination (even small amounts)
Difficulty urinating
Numbness around the genitals, anus or buttocks
People under 20 and over 55 years of age
Patients who have been taking steroids for several months
Patients with or with a history of cancer or with a low immune system
Drug abusers

Back pain treatments

The methods conventionally used for back pain generally depend on whether the pain is acute (lasting less than 3-6 months) or chronic (lasting more than 6 months).

The methods generally used are listed below.

Medication – If the doctor prescribes over-the-counter painkillers and the response is not positive, a prescription for a non-steroidal anti-inflammatory drug (NSAID) may be necessary. Narcotics such as codeine or hydrocodone may also be prescribed for short periods and require close monitoring by the doctor. If you suffer from depression, antidepressants can alleviate back pain, according to some studies.
Hot or cold compresses – For temporary relief at home, a hot or cold compress on the injured area is ideal. Results may be slow, but compresses can help relieve pain and reduce inflammation.
Strengthening exercises – Regular exercise not only strengthens the back, but also keeps the body weight down. Low-impact aerobic activities that do not strain the back are essential. Focus on exercises that involve the core and fine-tune your flexibility to prevent back pain. Before starting any kind of exercise programme, talk to your doctor.