What’s behind that back pain?

BACK pain is one of the most common health complaints for both men and women. Though it is so common that it has almost become normalised, back pain is no joke, especially when it is persistent and accompanied by other symptoms.

Dr Samantha Nicholson-Spence is a doctor of internal medicine, and she says back pain is usually not a cause for concern on its own in most patients, and even in cases where it is persistent it is not necessarily serious.

“Most times back pain can be attributed to lumbago, which is a condition that refers to pain in the lower back,” she told All Woman. “This is just musculoskeletal pain. This can arise after you lifted a heavy object, you carry heavy loads frequently, if you had a car accident or trauma, your chair is bad, your bed is bad, or your posture is bad so every now and again you get back pain.”

She noted, however, that this type of back pain is not usually debilitating, and the symptoms usually flare up for a while then go away. Certain medical conditions such as arthritis, she said, can predispose a patient to back pain, which would be no cause for concern. Some women also experience back pain just before their periods as a part of premenstrual syndrome.

Dr Nicholson-Spence pointed out that while it is often difficult to pinpoint the root cause of back pain, it is important to watch out for other symptoms to be able to spot a red flag.

“If you have back pain and you are also having trouble passing urine, have lost a lot of weight, have night sweats, fever or constipation, then those could be red flags for a more serious condition,” the doctor cautioned.

“If you’ve had cancer before, or you have a family history with cancer or any symptoms that may be linked to cancer such as a lump in your breast, or if you are a smoker, then that could be another red flag,” she said.

A worrisome sign, she highlighted, is if a patient is experiencing loss of sensation in the limbs with their back pain.

“For example, if you have weakness in legs, a loss of coordination, you are falling down, or if you feel numbness or tingling in the lower extremities or even in the hands, this would suggest that there is nerve involvement,” she explained. “Whether it’s the spinal cord that is affected or the nerve roots that are coming out of the spinal cord, it gets serious when these become involved.”

Dr Nicholson-Spence said that these symptoms could indicate that there is spinal cord compression, which is an emergency.

“If you don’t do something quickly it can lead to permanent loss of function. Sometimes it can go from just a tingling feeling in your legs to being bedridden or wheelchair-bound if something is not done within a matter of hours.”

She added: “Not being able to hold your urine with back pain can also be an indication of spinal cord involvement.”

While back pain typically radiates down the middle of the back along the spine, Dr Nicholson-Spence said that taking note of where the pain is located can help to spot what’s behind it.

“So if the pain spreads across the flank (between the ribs and hip) and you have pain that is persistent, and there is blood in the urine or fever, that could indicate an issue with the kidneys,” she noted. “In the worst case that could mean kidney cancer, but it can also be due to kidney stones and kidney infection.”

She added: “Pain that feels as if it’s running down your leg, that feels as if you have an electric shock sensation that runs from the lower back down into the leg, that can occur if you are having compression of a nerve root such as if you have a herniated disc (what Jamaicans call ‘slipped disc’). While a herniated disc is not life-threatening it can cause disability, in that you are in so much pain that you cannot function properly.”

The doctor advised that when you have back pain you should keep moving if you can.

“When you have back pain the answer is not to lie down in bed and take time off, because that can make back pain worse,” she said. “The best option is usually to try to keep moving around. If you have to take painkillers, then do so and just try to keep active as much as possible, and try to see your doctor if it is associated with any other symptoms.”