Back pain is a common problem, affecting 80 percent of people at some point in their lives. But not everyone's discomfort is the same and some signs and symptoms are more troubling than others.

Garden-variety back pain is often the result of a strain, which occurs when muscles or tendons in the back are overworked. Such small injuries account for a majority of cases of back-related discomfort.

Back pain that's severe or persists for several weeks, on the other hand, should be evaluated by a doctor. Wayne Kelley, MD, a spine surgeon in Macon, Georgia, notes that back pain that crops up with other symptoms – such as bowel or bladder problems or progressive neurological changes, like sudden or severe headaches or vision problems – also require immediate attention.

Here, Dr. Kelley offers his expert insights on which types of back pain and related symptoms may be indicators of significant spinal conditions that require medical attention.

Leg Pain and Weakness

Pain that originates in the lower back and travels down the legs – also known as sciatica – may signal a serious problem. Kelley says culprits may include a herniated disk or spinal stenosis. Both conditions cause the space around the spinal nerves to narrow, which may result in nerve pain and irritation.

Like back pain, pain through the back of your legs may be dull or severe and can come in quick bursts, worsened by coughing or sneezing. Discomfort caused by a herniated disk typically travels down one side of the body. Pain from spinal stenosis typically affects both legs, sometimes in their entirety.

Like back pain, pain through the back of your legs may be dull or severe and can come in quick bursts, worsened by coughing or sneezing. Discomfort caused by a herniated disk typically travels down one side of the body. Pain from spinal stenosis typically affects both legs, sometimes in their entirety. Most pain caused by sciatica or a herniated disk will improve within six to eight weeks without surgery. But if pain in the arms or legs lasts longer than a week, becomes severe or is accompanied by muscle weakness or difficulty controlling your bowels or bladder, seek immediate medical attention.

Loss of Bladder or Bowel Control

"When you can't empty your bladder or you can't go to the bathroom, those are urgent things that require immediate medical attention,” Kelley says.

Bladder or bowel incontinence may be signs of nerve compression caused by a ruptured disk. If left untreated, nerve compression can lead to permanent neurological damage.

Stiffness in the Morning

It’s not always easy to get out of bed, but excessive morning back pain and stiffness could be a sign of spinal arthritis. Most types of arthritis – including osteoarthritis and rheumatoid arthritis – cause pain and stiffness that worsen toward the end of the day and after periods of rest, like a night's sleep.

Any part of the spine can become arthritic, but the lower back (lumbar region), is most commonly affected. Thankfully, there are ways to manage the condition. Once diagnosed using a physical exam and x-ray imaging, spinal arthritis can be treated with pain medication and physical therapy. Surgery is needed in rare cases.

Protect yourself before it's too late. Getting regular exercise, maintaining a healthy body weight, practicing good posture and doing your best to avoid spinal injury all decrease your risk for spinal arthritis and other back-related issues.

June 19, 2018
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