Do I Need To See A Doctor For My Back Pain?
No matter what the ailment, deciding when to go see the doctor is the hardest part. We choose to draw an invisible line that if the pain isn't overbearing or the rash isn't too bad, we'll wait it out.
This couldn't be more true for back pain. Back pain is a mystery ailment that could be anything from no big deal, sleep it off, to you needing unpleasant invasive surgery to fix this.
In reality, back surgery success rates aren't very high, estimated between 10%–46%. As a result, you may not want your first call to be a physician. A common occurrence in our healthcare system for someone with back pain goes like this:
You go to the doctor for back pain, and the doctor suggests you need to see a surgeon or specialist to X-Ray or MRI your back. The surgeon, being a surgeon, recommends surgery.
When all you have is a hammer, everything looks like a nail. With the abysmal success rate of back surgery, you may not want to go down that road. Although often with HMOs or Medicare, you have no choice. With any ailment, you must first go to an internist to help determine your next course of action.
With all that in mind, how do you know when to see a doctor for your back pain?
To be honest, I don't know. My specialty is helping people get strong. However, my friends Dr. Richelle Caya and Dr. Daniel Robinson over at Montri Wellness are better suited to answer this question and many other common back pain questions.
We'll have them give their input on a few common back pain questions to help you decide how to manage your back pain best.
Will my back pain heal itself over time?
Do I even need to do anything?
Time heals all wounds…but it doesn't necessarily heal them properly or allow you to go on living a pain-free life.
“There are many times when you tweak your back and a few weeks of relative rest is all you need. In fact, most back pain episodes will resolve in 6-8 weeks. While healing, it is important to remember that relative rest does not mean staying in bed or on the couch all day. Relative rest means taking a break from vigorous activities, like sports or heavy lifting, but still walking, doing your normal routine throughout the day, and completing some gentle exercises. There are some pretty basic stretches that can do wonders for some minor back issues in the early stages of a back pain episode.” (Dr. Richelle Caya, PT, DPT)
BASIC STRETCHES FOR MINOR BACK PAIN
1. Open Books
Start on your side in this slightly modified fetal position.
Then while trying to keep your knees on the ground, attempt to open up (like a book) and reach your top arm all the way to the floor. Turn your head and look towards the arm that is reaching for the floor.
2. Child’s Pose
Start on your hands and knees, relax your feet, put your big toes together, and have your knees hip-width apart. Sit back onto your heels and bring your head to the mat. Reach your arms out in front of you and every time you exhale, sink deeper into it.
3. Cat/Cow
Starting on your hands and knees, push away from the floor and attempt to reach your back towards the sky. Relax your neck and let your head fall towards the floor.
Next, transition from the cat position to the cow position, MOOO! Look up towards the sky and let your stomach drop towards the floor.
“The most important thing is to remember that your back is a very strong and stable structure, and it is built to handle all planes of movement. Pain is a very complex issue, and it can be very frustrating, especially since back pain episodes tend to occur more than once in a lifetime. The good news is that back pain doesn't necessarily mean any harm is happening to your tissues. The best thing to do for a back pain episode is to remain as active as possible and gradually return to your pre-injury lifestyle over the course of 1-3 months.” (Dr. Daniel Robinson, PT, DPT)
Should I go to a physical therapist instead/first?
You don't always need to see a doctor for every issue. If you have knotted-up shoulders, you'll probably go to a massage therapist, not a doctor. The same is true for some types of back pain. Often, back pain resolves on its own with relative rest, but even more complicated back pain episodes are still typically muscular in nature and handled best by a physical therapist.
Most physical therapists have doctoral degrees and are trained to screen and refer patients back to medical doctors when necessary. While in the past, a primary physician often operated as a gatekeeper to treatments like physical therapy, it is now possible in many states to see a physical therapist without a referral.
This can save you time, money, and the potential side effects of unnecessary imaging. Dr. Richelle Caya, PT, DPT, and Dr. Daniel Robinson, PT, DPT with Montri Wellness recommend seeing a physical therapist if:
It is your first bout of back pain, you have questions about your back pain, or you are worried about your back pain. A physical therapist can give you assurance by screening for serious issues, help you find symptom-relieving treatments, and teach you how to get back to doing what you love.
Your back pain is not getting better after a few weeks. This usually doesn't indicate that anything serious is going on, but it may mean that you need a personalized plan.
Your back pain radiates to your legs. It is not uncommon for back pain to also affect the buttocks and the legs. It can be a little more complicated to resolve, and you may need to see a physical therapist for help.
You want professional guidance through the healing process. A physical therapist is there to guide you back to your physical activity goals. They use a combination of hands-on manual therapy and specific exercise that is tailored for you. For some back pain episodes, you may only need a few sessions with a physical therapist to feel better and learn what to do to manage the rest of your recovery on your own.
When is it time to go to the doctor?
We have bashed your general practitioner enough for one article. Doctors are obviously necessary in some back pain cases, even though they will often recommend physical therapy as the primary treatment method. Often, but not always. Occasionally, back pain can indicate a more severe issue that requires a medical professional. Here are some signs you should look out for:
Difficulty urinating
Urine leakage
Numbness in the groin
Unintentional weight loss
Stumbling when you walk
Feeling so weak that you can't lift your legs
Pain that never changes, no matter how you move or position yourself
If you are experiencing any of these symptoms, you should call your provider right away.
More often than not, you don’t need to make a trip to your physician.
“Most back pain will resolve on its own if you follow a regime of relative rest and gradual return to activity. Very rarely, back pain can indicate something serious, so if you notice any changes in your ability to control urinating, severe weakness in your limbs, or pain that never changes, you should call a medical provider. Generally, if you are unsure of what to do about your back pain, you should consult a physical therapist first and consider some treatment sessions to relieve symptoms and get some guidance on helpful movements and exercise. “ (Dr. Richelle Caya, PT, DPT, and Dr. Daniel Robinson, PT, DPT with Montri Wellness)
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