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Show ; ton EiagCi Me Sgg lister-? v. ft WCH0LASDANFORTH M.I. y anatomy tf low back , ;-:;andasimplehome plan : tow to care fo low back tiin was the sulject of a "mous article, 'oday, we ..' ill talk about vhen you -mid go to the dctor with ': nkkpain. Wi TO go to tb doctor f j crucial questivi. The M cause of low bak pain a muscle or ligment jblem, A self-presribed : raiment of bed resi heat . :i aspirin is normall suc- asful within 48-72 hou. . 3m there are other Coses - low back pain whee a .; : .3ician's guidance ma be ' i.pful.1 divide these intowo '" L-as - those that demnd ;J go to the docor immediately and those that suggest you go to the doctor at your convenience. YOU SHOULD go to the doctor immediately with the following: low back pain associated as-sociated with loss of bowel or bladder function; low back pain with the acute onset of pain which travels through both buttocks and down the back of both thighs. These two situations suggest sug-gest a disc (the "shock-absorber" between each vertebrae) ver-tebrae) has ruptured in such a way that neurological problems may result unless the disc is removed. LOW BACK pain which gets steadily worse with bed rest. There are a number of condi-. condi-. tions unrelated to the spine and its muscles and ligaments which show up as back pain. Some are emergencies; emer-gencies; some are not. A good rule of thumb in all painful conditions is to think of a graph the faster and more severe the pain becomes, the more quickly you should go to the doctor. IT IS NOT necessary to rush to the doctor in most cases. However, you should make an appointment to see your doctor, doc-tor, at your convenience, with the following: 1. More than one bout of acute low back pain in six months. This is probably playing it too safe because the majority of cases of low back pain are recurrent. But more than one attack, even if the first responds to bed rest, suggests you would benefit from an opinion on what is the cause and what you can do to prevent recurring attacks. 2. LOW BACK pain which doesn't get better with adequate bed rest. If the pain nags on and on, you need an opinion. Underlying problems with the vertebrae ("wear and tear" arthritis, bone tumor, curvatures, etc.), can cause a chronic nagging type of back ache and thus should be evaluated. I might add that the usual findings are negative and what you'll need is an exercise exer-cise program. 3. SCIATICA sciatica is defined as pain which runs from the low back, through the buttocks and down the back of the thigh. Most people describe it as a deep severe toothache type of pain or a shooting or stabbing type of pain. It is caused by an irritation irri-tation of a nerve Voot and suggests you may have a disc problem. It is made worse by coughing, sneezing and motion. mo-tion. If you have low back pain and one-sided sciatica, chances are good that your treatment will be complete bed rest, heat, a pain medication and maybe a muscle relaxant. I personally .think 48-72 hours bed rest,-' rest,-' heat and aspirin is worth a try before going to the doctor. IF YOU gradually begin to feel better, continue the treatment. Most of us need a physician's opinion if we are to miss more than two or three days of work and it may be that this condition will take up to three weeks of this treatment. Remember that sciatica on both sides demands immediate physician evaluation. evalua-tion. 4 NUMBNESS, tingling or muscle wasting. If you feel an area in your leg or foot that feels numb, hot, "tingling," -"funny," "not there" (or a host of other abnormal feelings) and you have or have had low back pain, I think you should see a doctor. Again, the chances are you'll hear the same old advice (and it's good advice) but it is important im-portant to document these symptoms in your record so they can be followed. The same goes for muscle shrinking or weakness. And, while you're at the office, of-fice, your doctor will check your "reflexes." All of these can help decide whether or not you have a nerve root which is being irritated. WE HAVE now covered the anatomy of low back pain, home treatment, and when you should seek medical attention. at-tention. How to help prevent recurrent back pain will be discussed in a future article. Dr. Danforth, former Associate As-sociate Dean of Dartmouth Medical School, is currently medical director of Family Health Program of Utah (FHP). |
