Lower Back Pain: Causes and When to Seek Help

Lower back pain?

At the beginning of the year, I slipped at work and experienced lower back pain.
I applied some medicated patches a few times, and then I didn't feel the pain anymore.
However, after the school semester started and I returned to work, I began to feel lower back pain again, which has worsened to the point where it hurts to walk and bend over.
Maintaining certain postures for too long also causes pain.
My job involves working as a timekeeper at a hotel, where I frequently lift heavy objects and bend over.
I would like to know if this is related to my slip or if it's due to poor posture from exercising or working.
If it is, which specialist should I see?

Cǎoméi, 10~19 year old female. Ask Date: 2015/10/31

Dr. Jiang Junyi reply Neurology

Hello, based on your description, your symptoms are more consistent with a herniated disc compressing the nerve root.
The spine is subjected to repetitive stress, especially from abnormal pressures such as bending to pick things up or working in a bent or twisted position for extended periods, which can lead to disc herniation.
Sudden injuries, such as twisting the torso suddenly, bending to lift heavy objects, or experiencing excessive force, can also compress the nerve root and result in lower back pain, which may radiate to one or both sides of the buttocks or hips.
If a herniated disc compresses the nerve root, it can lead to neuropathic pain.
Symptoms may include sharp, stabbing pain, numbness, sensory deficits, diminished reflexes, and muscle weakness.

It is recommended to rest in bed for a short period of 1-2 days to alleviate local pressure and pain.
You may also use a back brace to reduce pressure on the affected disc, gradually decreasing the time wearing the brace to avoid dependency and muscle atrophy.

In terms of treatment, anti-inflammatory and analgesic medications can be used, or muscle relaxants to relieve discomfort in the back muscles.
It is advisable to undergo active rehabilitation for six weeks.
If you continue to experience leg pain or numbness in the feet after six weeks, or if symptoms worsen, surgical intervention may be necessary.
I suggest consulting with a neurologist or a rehabilitation specialist for further discussion and treatment.
Wishing you good health and well-being.

Reply Date: 2015/10/31

More Info

Lower back pain is a common issue that can arise from various causes, including previous injuries, poor posture, and repetitive strain from work activities. Given your situation, where you experienced a slip and fall earlier in the year and are now experiencing pain that worsens with certain movements or prolonged positions, it is essential to consider several factors.

Causes of Lower Back Pain
1. Previous Injury: Your initial slip and fall could have caused soft tissue damage, such as muscle strains or ligament sprains, which may not have fully healed. Even if you felt better for a time, underlying issues could resurface, especially with increased physical activity.

2. Repetitive Strain: Working as a hotel staff member often involves lifting heavy objects and maintaining awkward postures, such as bending over. These activities can lead to muscle fatigue and strain, contributing to lower back pain.

3. Poor Posture: Maintaining poor posture while standing, sitting, or lifting can place additional stress on your back. Over time, this can lead to chronic pain and discomfort.

4. Muscle Imbalance: Weakness in core muscles can lead to poor support for the spine, increasing the risk of injury and pain.

When to Seek Help
Given that your pain has intensified to the point where it affects your ability to walk and perform daily activities, it is advisable to seek medical attention. Here are some signs that indicate you should see a healthcare professional:
- Persistent pain that does not improve with rest or over-the-counter pain relief.

- Pain that radiates down your legs, which could indicate nerve involvement.

- Difficulty in performing daily activities or work tasks due to pain.

- Any new symptoms such as numbness, tingling, or weakness in the legs.

Which Specialist to See
For your situation, the best course of action would be to consult a physiatrist (a specialist in physical medicine and rehabilitation) or an orthopedic doctor who specializes in spine issues. They can perform a thorough evaluation, which may include a physical examination and possibly imaging studies like X-rays or MRI to assess for any structural issues.

Management and Treatment Options
Once you have consulted with a specialist, they may recommend a variety of treatment options, including:
1. Physical Therapy: A physical therapist can design a personalized exercise program to strengthen your core muscles, improve flexibility, and teach you proper lifting techniques to prevent further injury.

2. Pain Management: Depending on the severity of your pain, your doctor may prescribe medications, such as NSAIDs (non-steroidal anti-inflammatory drugs) or muscle relaxants, to help manage your symptoms.

3. Activity Modification: Learning how to modify your work tasks to reduce strain on your back is crucial. This may include using proper lifting techniques, taking regular breaks, and alternating tasks to avoid prolonged positions.

4. Ergonomic Assessment: An ergonomic assessment of your work environment can help identify potential improvements to reduce strain on your back.

5. Alternative Therapies: Some individuals find relief through alternative therapies such as acupuncture, chiropractic care, or massage therapy.

Conclusion
In summary, your lower back pain may be related to your previous injury, work-related activities, or poor posture. It is essential to seek medical advice to determine the underlying cause and receive appropriate treatment. Early intervention can help prevent the pain from becoming chronic and improve your overall quality of life. Remember to listen to your body and avoid activities that exacerbate your pain until you receive a proper diagnosis and treatment plan.

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