Top 5 Causes of Back Pain
The most common causes of back pain are self-treatable,
self-diagnosable problems. For adults, back pain is usually a temporary
infliction that becomes more common with age. However, there are also
several more serious causes of back pain that require medical
Injury to a Muscle
Injury to a muscle, or a strain, is the most common cause of back
pain. It is also commonly referred to as a pulled muscle. In these
cases, muscle or a tissue connecting muscle to the bone called a tendon
stretches or tears. In most cases, these afflictions affect the lower
back, but they can occur in other areas of the back, as well. Symptoms
typically include pain, swelling, possible muscle spasms and limited
mobility of the affected muscle or tissue. In most cases, a pulled
muscle resolves itself within days to weeks. Treatments include home
remedies such as over-the-counter pain relievers, ice, heat application,
rest or splinting.
Ligaments are bands of fibrous tissue that connect bones to joints.
When a ligament is injured, it presents much like a muscle strain but it
is actually referred to as a sprain. These occur when a ligament is
stretched or torn. In your back, there are 14 spinal ligaments. In
general, ligaments are not very flexible, which is why they are prone to
injury. If you’ve experiences a ligament strain you will likely notice
limited range of motion in the affected area, pain or tenderness, muscle
spasms, inflammation or bruising. These symptoms can occur all
together, or you may just experience a few. Because ligament strains are
common, they can usually be treated at home with ice, rest,
compression, over-the-counter anti-inflammatory medications and keeping
A disc problem
When back pain is chronic (i.e. lasts three months or more and occurs
frequently), there is likely a more serious underlying issue that needs
to be addressed. A disc problem is one of the most common causes of
chronic lower back pain in adults and usually appears as a herniated
disc in the lumbar or is caused by a degenerative disc disease. When a
lumbar disc herniates, the inner portion of the disc breaks through the
tough outer portion causing severe pain in the lumbar spine. The pain is
caused by irritation of the nerves in the back, usually as the
herniated disc creates swelling in the nerve roots. A degenerative disc
disease occurs when the invertebral discs in the back begin to dehydrate
over time. This causes the discs to wear down and become more
susceptible to injury. Too much force on dehydrated discs can tear,
weaken and become painful, often leading to a herniation.
Scoliosis is curvature of the spine. It is considered a deformity and
depending on how severe the curvature is and where it is located, it
can result in back pain. Scoliosis can also lead to the breakdown of
discs and joints in the back. For this type of affliction, severity and
pain levels often determine treatment. Some with minor curvature can
benefit from stretching and massage appointments, others result to
chiropractors for correction of the curve but in other cases a brace or
surgery is recommended.
A nerve issue
There are three common types of nerve root issues that lead to back
pain: spinal stenosis, spondylolisthesis and osteoarthritis. In all
three conditions, the nerve root is affected causing often-severe back
pain. In spinal stenosis the pain results from narrowing of the spinal
canal near the nerve roots. It can appear in one area, or several areas,
of the back. In spondylolisthesis, a vertebrae slips over another
vertebrae and creates a painful, unstable back. Spondylolisthesis most
commonly occurs with joint issues, typically after a fracture or a
degenerative joint disease, or as the result of a defect to the joints.
Lastly, osteoarthritis occurs when both discs and joints begin to wear
down. This ailment becomes more common as people age and leads to pain,
swelling, instability and stenosis in one or several areas of the spine.
7 Steps to be a Good Medical Patient
Everyone knows the importance of having a good doctor. If you want to optimize your medical experience, however, it’s important to also be a good patient.
1. Identifying your symptoms
To help a doctor properly diagnose you, it’s important to be thorough in the description of your symptoms. The more details, usually the better. A good practice to adopt is to write symptoms down along with information about when they started. Then, when you are at your appointment, you’ll be able to provide detailed, accurate information.
Any and all symptoms should be recorded. Sometimes what may seem insignificant to you could be the information that leads your doctor to make a diagnosis. However, there is a difference between being a good patient and attempting to do your doctor’s job for them. While recording and properly identifying your symptoms is good practice, attempting to diagnose yourself is not. Record and monitor symptoms but do not begin jumping to conclusions about your condition. You can share concerns, fears or opinions with your doctor, but showing up with WebMD results does not a good patient make.
2. Scheduling appointments
When possible, schedule your appointments in advance. For seasonal checkups or routine appointments, giving your doctor time to fit you properly into their schedule may lead to better care. This way your doctor won’t be tasked with trying to fit you into an already busy schedule.
There are of course times when scheduling appointments in advance is not possible. In many cases, an unexpected illness arises and you have no choice but to call your doctor hoping for a same-day appointment.
One way to handle this situation is to chat with your doctor. Some physicians would prefer a phone call when symptoms start to get you into the office within two to three days with the understanding that you may cancel the appointment if your condition changes. In another cases, this may be more of a nuisance to your doctor. Have an open, honest conversation about their preferences, office policy and standard wait times for appointments.
When you are calling last minute, flexibility is key. Many doctors will fit you in even if their schedule is full. Be willing to take any appointment time and wait a little longer in the office if necessary. Walking into the situation with these expectations will make it easier to endure, and your flexibility is more likely to lead to a positive outcome. There is also potential that a colleague will be able to fit you in, so if you are okay with not seeing your primary physician, you could benefit.
When an appointment is not available and you cannot wait for a later one, ask about your options. There are often urgent care centers or emergency rooms open that can serve you. The staff at the doctor’s office may be able to tell you which type of office to visit, as well as nearby options that accept your insurance.
3. Presenting your symptoms
If you’ve followed step one then you have already been tracking symptoms. Writing this information down is a good way to ensure you do not forget. It also allows you to show your doctor your symptoms versus telling them.
When presenting symptoms, think about the words you’ll use and try to be accurate. Announcing that you had a fever for two days can be misleading if you don’t provide additional details. For example, most physicians don’t consider a rise in temperature a fever until it reaches 100.4 degrees F. That’s because slight variations in temperature are normal and most thermometers have a small range allotted for error. Using information such as “low grade” or “high grade” when discussing fever is a good example of presenting your symptoms accurately.
The same rule applies to all symptoms, and the more information you provide, the less follow-up questions your physician will need to ask.
4. Asking good questions
This is an important step to making the most of your doctor’s visit as being face to face with your doctor is often the best time to ask medical questions. Your questions may be related to your diagnosis, treatment or personal preferences. Be proactive and don’t limit your questions to the reason that sent you to the doctor initially (however don’t bombard your doctor with questions either).
Seeing a doctor is about continued health, not just curing the ailment at hand. A good practice is to ask your doctor what health-related items you could work on before your next visit. It could be a simple diet change, a challenge to exercise more or a more general piece of advice, such as stress less. Either way, when you’re face-to-face with a medical professional that has access to your personal health history, what better question could you ask about continued health?
A good rule of thumb for establishing good questions and opening a health-conscious dialogue with your physician is to consider the future. Are you guilty of googling medical advice? Ask your doctor what sites they recommend for knowledgeable medical information. Is your problem turning chronic? Ask how to prevent a specific illness in the future. With a doctor, you can pick their brain about weight loss advice and personal health goals. It’s also acceptable to question the prescriptions you are given. Ask why you are taking a specific medication to learn its function, or even ask about the necessity of certain pills. Are there negative side effects? Perhaps they aren’t worth the risk to you.
A common example of questioning medication is antibiotic use. If you are prescribed an antibiotic, ask if the treatment is necessary. Many times a physician will tell you it’s okay to take a wait-and-see approach and only fill the prescription if symptoms worsen or do not resolve within an allotted time period.
5. Follow up
Whether you saw your primary doctor or an emergency room doctor, physicians like follow-up. This is most important if a problem does not clear up or returns. For example, if you head to the doctor with joint pain complaints and are treated with pain relievers and home therapies but the pain doesn’t resolve, you need to see your doctor again. There may be reason for additional tests or a more intense rest period, however there is no way to know that if you don’t call and inform the doctor of changes, or a lack thereof.
What it comes down to is being your own advocate. Your doctor may be the medical expert, but you’re the you expert. You know you best and when something isn’t feeling right, calling the doctor to follow-up isn’t a nuisance, it’s a necessity. Sometimes doctors appointments offer little more than reassurance that the mole you’ve been stressing over for months is nothing to be afraid of, but in any case it’s a worthy use of your time.
6. Following doctor orders
This can be a hard pill to swallow, literally. Not everyone likes the advice a doctor gives him or her, but almost 100 percent of the time the advice given is in the patient’s best interest. Try to put aside pride and do what the doctor tells you. If the doctor’s orders insist on a lifestyle change, then see it through. If you were prescribed a medication and your doctor has reiterated that it is necessary, take the full course.
You see a medical doctor for a reason. They have several years of schooling in medicine and that makes them experts in how to treat illnesses and manage health. You may not like hearing that your BMI is higher than average or your sudden weight loss has an underlying cause, but you went to your doctor with your concerns for a reason. Why go if you aren’t going to heed their advice? And if you truly disagree with a treatment, seek a second opinion. Most physicians encourage it.
7. Maintaining health
There’s no one-size-fits-all approach to health. There are rules that apply to most, such as eat healthy, exercise frequently and take vitamins, but for every rule there is an exception and that exception could be you.
For the most part, following doctors orders and committing to a good check-up schedule is a good place to start. This keeps the dialogue with your physician open and frequent appointments can be used to manage a specific illness or medical concern.
Follow these steps to being a good patient and listen to your physician’s advice. When you have health concerns, call, and when you’re unsure, ask questions. Never ignore symptoms that don’t go away and always be your own advocate. It’s your job to manage your health. A doctor can help, but not if you don’t approach them honestly about your concerns.