Lower back pain: When to seek care

man with lower back pain working on steam engine

Lower back pain is common. At-home treatments may help but if symptoms are persistent or worsen, it’s time to talk to your provider.

If you’re suffering from lower back pain, you may take some small comfort in knowing you’re not alone.

In fact, four in five people in the U.S. will be affected by lower back pain at some point in their lives.

Lower back pain self-care

Fortunately, lower back pain relief can be found most of the time with rest and over-the-counter medication. Some people can benefit from applying cold compresses or ice for 20 minutes, several times a day. Use a pad of some kind between the cold source and your skin.

“Generally speaking for any neck or back pain, if improvement isn’t seen in one-to-two weeks with rest, ice or heat and pain medication, then scheduling an appointment with your doctor or physical therapist is appropriate,” said Jeff Darling, physical therapist with Marshfield Clinic Health System.

Darling shared common questions you may be asked about in regards to your lower back pain:

How did the pain start?
- Was there any precipitating event?
What does it feel like (an ache, burning, pressure, sharp, shooting, stabbing, pins and needles, etc.)?
Is it constant, or does it come and go?
What increases the pain?
What alleviates or reduces the pain, if anything?
Does it shoot or radiate anywhere else?

Pain management

After your provider discusses your symptoms and orders diagnostic exams, then you may be referred to a specialist like Dr. David Junker, a Marshfield Clinic Health System pain management specialist.

“Our spine management program is truly comprehensive,” said Junker. “We focus on not just giving pills and injections but treating the whole person. There is a psychological component, as well, because of stress that goes along with pain. We’re one of the rare programs integrating that issue.”

Marshfield Clinic Health System’s pain management program:

Starts with conservative back pain treatments such as medications, rest, rehab and/or therapy.
Moves on if necessary to interventional procedures, such as steroid injections into the spine; radiofrequency ablation using radio waves to “ablate,” or destroy nerves that sense pain in joints, neck and back; and spinal cord stimulator therapy. Spinal cord stimulator therapy sends an electrical signal to the spinal cord blocking pain signals from reaching the brain; and is especially useful to treat nerve pain from the neck or low back that radiates into arms or legs.
Includes neurolytic blocks, often used to treat cancer pain for people who are in their end stage of life.
Diagnostic injections of nerves to pinpoint where pain is coming from.

“By far our most common procedure is the epidural steroid injection,” Junker said. “We use it for pain from the sciatic nerve running through the low back and legs. It is useful to decrease pain from swelling and inflammation.”

When to seek emergent care

A certain area of pain in the back or neck doesn’t necessarily warrant immediate attention unless the pain is severe. Darling recommends urgent care or emergency care when it gets debilitating.

Symptoms that can occur with neck or back pain that warrant immediate attention would be saddle paresthesia, which is numbness and/or tingling of your inner thighs and groin (the areas of contact if you were sitting in a saddle). Additionally, loss of bowel or bladder function, or loss of function or movement of a limb, are symptoms that should be treated immediately.

“These symptoms would indicate compromise to the spinal cord or nerve roots coming out of the spine, for which the spine is there to protect,” Darling said. “These symptoms do warrant immediate attention at your closest emergency room.”

Schedule an appointment with your primary care provider for a referral to find a solution for your back pain.

“Chronic pain cannot always be cured but it can be managed to significantly improve patients’ quality of life,” said Junker.