When to Go to the Doctor with Severe Back Pain

By

Diana Kelly

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At any given time, approximately 31 million Americans are experiencing back pain. Half of all working Americans admit to having back pain symptoms each year and it’s one of the most common reasons people report missing work. Most cases of back pain are caused by poor posture, inactivity, or injury; however, some back pain can be caused by serious conditions, like rheumatoid arthritis (RA) or ankylosing spondylitis (AS). If you suspect your pain is caused by an underlying condition, it’s important to see your doctor to get a diagnosis and begin treatment.

Is Your Pain Acute or Severe?

Short-term (acute) back pain generally lasts from a few days to a few months. It might be caused by sprained ligaments, strained muscles, bulging or ruptured discs, arthritis or osteoarthritis, irritated joints, or trauma from a sports injury or housework. Back pain symptoms may range from dull muscle aches to shooting or stabbing pain.

If you’re experiencing severe symptoms of pain, like shooting or stabbing pain, limited flexibility and range of motion, or if you can’t stand up straight, make an appointment to see your doctor as soon as possible. If your symptoms don’t feel that extreme but you don’t have a noticeable reduction in pain and inflammation after three days of rest and heat or ice therapy at home, contact your doctor. Long-lasting (chronic) back pain is defined as pain that persists for longer than three months.

When It Might Be An Autoimmune Disorder

Ankylosing spondylitis (AS) is a form of arthritis that impacts the joints in the spine and impacts 200,000 to 3 million U.S. adults each year. AS causes inflammation in the form of pain, redness, heat, and swelling in the spine or vertebrae. It frequently involves an inflamed sacroiliac joint, where your spine connects to the pelvis.

AS can feel different in each person. Some may experience mild back pain that comes and goes. Others will suffer from severe, ongoing pain. It’s important to treat AS, as the condition can diminish flexibility in the spine. In some extreme cases, inflammation caused by AS can cause two or more bones of the spine to fuse together, which can stiffen the rib cage and even restrict lung capacity.

Prep for Your Appointment

Make sure you jot down any recent activities or a specific instance that may have caused your pain. If your muscle aches ebb and flow and range from dull to shooting pain, note those details, as well as how long the pain lasts and the ways it’s affecting your quality of life (like if you’re not able to go to work, spend time with family, or having trouble sleeping).

Treatment for Standard Back Pain

To treat more common cases of back pain, your general practitioner will likely recommend several self-care solutions and perhaps a referral to a physical therapist or chiropractor. Hot or cold compresses may help reduce aches and inflammation and provide you with a better range of motion. Your physician may prescribe over-the-counter pain relievers, muscle relaxants, topical pain relievers, or injections. He or she might tell you to exercise more once the pain has subsided, since exercise is thought to be one of the most effective ways to speed recovery from low back pain while strengthening back and abdominal muscles. In the most serious cases, when the condition does not respond to other therapies, surgery may relieve pain caused by back problems or serious musculoskeletal injuries.

Treating Ankylosing Spondylitis

If your physician suspects your back pain might be AS, he or she should refer you to a rheumatologist, who is trained to address arthritis and related conditions. While there currently isn’t a cure for AS, your rheumatologist may suggest medicines like nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, inflammation treatments like disease-modifying antirheumatic drugs (DMARDs), or newer biologic agents. Your doctor may also recommend specific exercises, lifestyle changes, and self-help techniques that might relieve symptoms. In some cases, surgery may be needed to repair AS joint damage.

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Medical Reviewers: William C. Lloyd, III, MD, FACS Last Review Date: Sep 9, 2015

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Medical References

  1. Back Pain Facts & Statistics. American Chiropractic Association. http://www.acatoday.org/level2_css.cfm?T1ID=13&T2ID=68
  2. Back Pain. MayoClinic.org. http://www.mayoclinic.org/diseases-conditions/back-pain/basics/definition/con-20020797
  3. What Is Ankylosing Spondylitis? Fast Facts: An Easy-to-Read Series of Publications for the Public, National Institutes of Arthritis and Musculoskeletal and Skin Diseases. http://www.niams.nih.gov/Health_Info/Ankylosing_Spondylitis/ankylosing_spondylitis_ff.asp
  4. NINDS Back Pain Information Page. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/backpain/backpain.htm

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