Back pain, especially in the lower back, is a very common complaint. It often resolves within a few weeks, but sometimes it lasts longer or returns. Below is information about the causes of pain, how sciatica behaves, and the signs that mean a person is taken to the hospital immediately.
Why the back hurts
Back pain can have many causes, and it is not always obvious which one it is. The most common cause is an injury such as a strained muscle. Sometimes the pain is caused by medical conditions: a disc herniation, sciatica (a pinched nerve), ankylosing spondylitis. Very rarely it is a sign of a serious problem — a fracture, a tumor, or an infection.
Disc herniation and sciatica
A disc herniation is when the soft cushion of tissue between the bones of the spine bulges out. It is the most common cause of sciatica, and such herniation occurs more often with age. Sciatica is irritation or compression of the sciatic nerve, which runs from the lower back to the feet.
Symptoms are felt in the buttock and along the back of one leg, often including the foot and toes: sharp burning pain, tingling, numbness, weakness. The pain worsens with movement, sneezing, or coughing. The back may hurt too, but usually less than the leg. If only the back hurts, sciatica is unlikely.
Symptoms may begin suddenly or build up gradually. Usually sciatica resolves within a few weeks to a few months, but it can last longer and return. Sciatica on both sides is an emergency sign, not a reason to wait for a scheduled appointment.
What else presses on the sciatic nerve
Besides a disc herniation, the cause can be spinal stenosis — narrowing of the part of the spine where the nerves pass. Also spondylolisthesis — a vertebra slipping out of place — and back injury. The mechanism is the same in all cases: something presses on or rubs against the sciatic nerve.
Risk factors
- age: disc herniation and sciatica become more common with the years;
- smoking, which increases the risk of sciatica;
- excess weight;
- lifting heavy objects without safe technique;
- prolonged sitting or lying down; poor posture, including at the computer.
When to go to the doctor
You see your family doctor routinely if the pain does not ease after several weeks of treatment, interferes with daily activities, does not go away after rest, or is stronger at night, worsens with sneezing, coughing, or defecation. Anxiety about the pain or difficulty tolerating it is also a separate concern for the doctor. Reasons for a conversation include unintentional weight loss, a lump or swelling on the back, a change in its shape, and also pain in the upper back, between the shoulder blades.
With sciatica, the reason to book an appointment is leg pain that worsens over time, does not ease after several weeks of home treatment, or prevents you from doing usual activities.
An urgent visit is a different level. Fever, chills, shivering, or general malaise along with back pain, as well as sharp severe pain that began suddenly or is rapidly increasing, are reasons to see a doctor urgently, without waiting for a scheduled appointment.
See a doctor immediately: call 103 or 112. An ambulance is called if back pain is accompanied by pain, tingling, weakness, or numbness in both legs, especially when the weakness or numbness is severe or increasing; loss of sensation around the genitals or anus; changes in urination — difficulty starting, inability to urinate, or incontinence; not feeling when you need to have a bowel movement, or being unable to control it; changes in sensation in the genitals, problems with erection or orgasm; chest pain; or if the pain began after a serious accident.
Such signs may indicate a serious back problem that needs help in a hospital as soon as possible. Emergency services are intended for life-threatening conditions, such as severe road traffic accidents, strokes, and heart attacks, and for serious injuries.
"Hang in there, it will pass" is not a plan if the pain persists for weeks. This text is for reference: it does not replace a doctor's consultation.
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This content is for reference and does not replace a doctor's consultation. Medical disclaimer