Post-Exercise Back Pain: When to Seek Medical Help

Lower back pain after exercise?

Hello doctor, I usually have a habit of exercising, but it seems that I have developed lower back pain due to incorrect posture while trying a new exercise.
After resting for three to four days, I felt better, but when I resumed exercising, the pain returned even worse the next day.
It has now been two weeks, and I suspect that my job, which requires prolonged standing, is also contributing to the issue.
The lower back pain seems to radiate discomfort to my back, legs, and the upper part of my buttocks.
I'm not sure which specialist I should see for this.

A-mei, 20~29 year old female. Ask Date: 2016/06/01

Dr. Jiang Junyi reply Neurology

Hello, based on your description, it may be necessary to consider the anatomical factors related to lumbar disc herniation.
Symptoms typically include radiating back pain, which may worsen with actions such as sneezing, coughing, or bending.
It is advised to avoid maintaining the same posture or performing the same movements for extended periods; instead, take breaks to stand and walk around.
Avoid prolonged exposure to moving cold air, such as having air conditioning or fans blowing directly on you.
Maintaining and enhancing muscle flexibility and strength through exercise is the most effective approach.
I recommend consulting with a rehabilitation specialist or a neurologist/neurosurgeon for further evaluation and treatment.
Wishing you good health and peace.

Reply Date: 2016/06/01

More Info

When experiencing post-exercise back pain, especially if it persists for more than a few days, it is crucial to understand when to seek medical help. Given your situation, where you have a history of regular exercise but have recently engaged in new movements that may not have been performed correctly, it is possible that you have strained your back muscles or aggravated an underlying condition.

Understanding Your Symptoms
Back pain can arise from various sources, including muscle strains, ligament sprains, herniated discs, or even issues related to posture, especially if you have a job that requires prolonged standing. The fact that your pain has not improved after several days of rest and has even worsened suggests that it may not be a simple muscle strain. Additionally, the discomfort radiating to your back, legs, or upper buttocks could indicate that the pain is more complex, potentially involving nerve irritation or other musculoskeletal issues.

When to Seek Medical Help
You should consider seeking medical attention if:
1. Pain Persists: If your pain continues for more than a week without improvement, it is advisable to consult a healthcare professional.

2. Severe Pain: If the pain is severe and limits your daily activities, including work, it is essential to get evaluated.

3. Neurological Symptoms: If you experience numbness, tingling, weakness in your legs, or issues with bowel or bladder control, you should seek immediate medical attention as these could indicate nerve involvement.

4. Impact on Quality of Life: If the pain affects your ability to perform daily tasks or exercise, it is time to consult a physician.

Which Specialist to See
For back pain, you may start with a primary care physician who can perform an initial evaluation. They may refer you to a specialist based on their findings. Here are some specialists you might consider:
- Orthopedic Surgeon: They specialize in musculoskeletal issues and can evaluate structural problems in your spine.

- Physiatrist (Rehabilitation Physician): They focus on rehabilitation and non-surgical treatments for musculoskeletal pain.

- Chiropractor: They can provide spinal manipulation and other treatments to relieve pain.

- Physical Therapist: They can help you with exercises and stretches to strengthen your back and improve flexibility.

Diagnostic Tests
Depending on your symptoms, your doctor may recommend imaging tests such as X-rays, MRI, or CT scans to assess the condition of your spine and surrounding structures. These tests can help identify any underlying issues such as herniated discs, spinal stenosis, or other abnormalities.

Treatment Options
Treatment for back pain often includes:
- Rest and Activity Modification: Avoiding activities that exacerbate the pain while gradually reintroducing movement as tolerated.

- Physical Therapy: A physical therapist can design a personalized exercise program to strengthen your back and improve posture.

- Medications: Over-the-counter pain relievers like NSAIDs (e.g., ibuprofen) can help reduce inflammation and pain.

- Heat and Ice Therapy: Applying heat or ice to the affected area can provide relief.

- Injections: In some cases, corticosteroid injections may be recommended to reduce inflammation.

Conclusion
In summary, if your back pain persists for more than a few days, worsens, or is accompanied by other concerning symptoms, it is essential to seek medical help. Starting with a primary care physician can help guide you to the appropriate specialist based on your specific needs. Early intervention can lead to better outcomes and help you return to your regular exercise routine safely. Remember, proper warm-up and cool-down exercises are crucial when trying new activities to prevent injuries in the future.

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