3 Reasons to Worry About Back Pain

Amy Graber PT, DPT

When should you worry about back pain? If your back is breakin’ and achin’ and you have one of these three symptoms, it might be time to call your doctor. However, MOST back pain is not accompanied by one of these more serious symptoms and can likely be managed by mechanical-based exercise or movement. Back pain is a very common concern we treat at Fit Family Physical Therapy.  If you are worrying about what may be causing your back pain or how to relieve your pain, we are here to help! 

Should I worry about back pain?

According to the Mayo Clinic, back pain is one of the most common reasons individuals visit their doctor or miss work and is a leading cause of disability worldwide. So, if you are experiencing back pain that is worrying you – you’re not alone! However, most people do not need to worry about back pain.

A majority of low back pain will resolve without traditional medical management or a visit to the doctor — up to 90% has been estimated to resolve in 2 weeks! The body is really resilient. If your pain persists longer than 2-3 weeks, it may be time to see a doctor to talk about next steps for treatment. This may be the time to worry about back pain, but still may not be the cause for any serious concern. A doctor or your regular provider may be able to recommend treatment such as physical therapy to help with this lingering pain.

The three main reasons to worry about back pain are:

• Back pain accompanied by persistent sensory changes in your legs (numbness in your feet or lower legs)
• Back pain and noticeable changes in bowel or bladder function
• Back pain specifically at night

If your back pain is accompanied by any of these symptoms, call your doctor and mention both the symptoms and back pain.

What are the top causes of back pain?

Generally speaking, a majority of back pain consults that we see as physical therapists can be classified as issues of load management for the spine. People are either over-doing it and causing acute injury to one of the muscles, joints, nerves of the back or they are under-doing it, leaving their back ill-equipped or too weak for even normal daily activity loads.

In terms of diagnosis, there are some studies that show up to 80% of back pain can not be attributed to a single anatomical structure in the back. This means that back pain is often nonspecific. An orthopedic surgeon or radiologist may be able to identify areas of concern on an x-ray, but in the research, there isn’t a common consensus as to whether these x-ray findings are the actual cause of pain.

Remember, most causes of back pain are no reason to worry! While you want to resolve the pain, back pain is a common concern and very treatable.

If physical therapy is recommended but that hurts too, what’s the next step?

If physical therapy is recommended and is painful, your first step should be to have a discussion with your physical therapist! A physical therapist is trained in the progression and regression of exercise as needed to help patients as they recover from pain or injury.

If you are unable to participate in physical therapy at all, there may be some benefit in trying aquatic based movement to allow for greater comfort while you perform exercise. 

If you’re unable to tolerate any activity at all, sometimes a discussion with your referring provider can help to see what other types of supplemental treatments can be utilized to allow you to tolerate the movement and activity associated with physical therapy and with your daily routine. These alternative conservative management techniques can include use of NSAIDs, possible epidural steroid injections, or even mindfulness meditation

Addressing the psychosocial components of pain is so important during the acute recovery stage. A majority of back pain resolves without lingering effects, but the mind is powerful. It’s important to address fear avoidance and movement hesitation early on if its hindering progress, because acute pain can quickly become chronic if these components are not addressed.

Best exercises for back pain

There is no need to worry about back pain — it’s very common! While back pain and lower back pain are very common, all back pain presents itself differently and activity tolerance is going to vary between patients.

Any activity is best! Progressive loading with the help from a professional is so important to make sure patients can be active safely throughout their recovery. Generally speaking, there are very few instances of back pain in which some type of movement or physical activity is not recommended. Bed rest is really a thing of the past when it comes to back pain management. We have to look at the impairments of the individual and treat those head on with a guided, safe, return to function activity program. 

If you are managing your pain without the help of a therapist or other healthcare provider, try low impact activities at first such as walking or even just wading in a pool. Progress to movement in multiple planes of motion that allows you to work without increasing pain levels.

Back pain treatments without surgery

There are many treatments that are recommended prior to surgery. You may see a physical therapist, chiropractor, or other movement-based professional that is trained to manage acute pain and prescribe safe movement/exercise. Other non-surgical management includes epidural or trigger point injections, use of NSAIDs, cryotherapy (ice), heat, or even massage based therapy. Many of these latter treatments can treat symptoms of pain well, but do stop short of helping your body return to its prior state of mobility and strength. A combination of all of these treatments would be recommended.

Still have worry about back pain?

Concerned about your own back pain symptoms? Need mobile physical therapy in Scottsdale? Contact us at Fit Family Physical Therapy for a free physical therapy consultation phone call. We can address your concerns and help you determine an appropriate course of action for your back pain and ease any worry about back pain! Skip the line with physician and insurance wait times, talk to us, and start your path to pain- and symptom-free activity today!

You can also check out our exercise library on YouTube! As always, if you’re unsure about your ability to perform any of these exercises, reach out to us or a healthcare provider first.

About the Author

Amy Graber PT, DPT has practiced physical therapy in a variety of settings. She has worked specifically with the pediatric population, assisting infants and young children reach developmental milestones, or rehabilitating young athletes. Amy has also worked extensively with adult patients and finds equal joy in helping adults reduce disability and reach their movement potential. She has specific experience with orthopedics, gait & balance training, and geriatrics.