Question 1: How long has my pain been present?
Less than 4-6 weeks
Back pain that has been present for less than 4-6 weeks is considered acute back pain. Acute back pain is highly likely to resolve on its own without medical treatment.
Patients with acute back pain usually do not require medical attention unless their back pain is highly debilitating, i.e, severely limiting your ability to perform daily tasks. If your pain is highly debilitating, medical consultation is recommended as it may be due to a more serious underlying condition such as severe disc herniation or compression fracture.
Longer than 4-6 weeks
If your back pain has lasted longer than 6 weeks, it could be time to see a specialist. Back pain lasting longer than 4-6 weeks is defined as subacute. Back pain that has lasted longer than 12 weeks is considered chronic. Unfortunately, the longer your back pain lasts, the less likely it will resolve on its own.
Question 2: Is my back pain getting worse?
If your back pain is becoming worse over time or severely limiting your daily activities, you should strongly consider scheduling a consultation with a medical specialist regardless of how long the pain has been present. The natural course of back pain should be steady improvement over time. Worsening pain indicates that the underlying cause of pain is not resolving in the usual manner.
Question 3: Has my back pain improved with conservative treatments?
If you’ve tried over-the-counter medications like ibuprofen or treatments such as physical therapy and you’re still in significant pain, it’s most likely time to be evaluated by a specialist. Back pain is so common that, even though the majority of patients will experience resolution within 6 weeks, many patients have persistent pain. Minimally invasive procedures such as steroid injections and nerve ablation can help patients achieve pain relief and avoid invasive surgical procedures.
Question 4: Do I have red-flag symptoms?
If you have worrisome or “red flag” symptoms, you could be part of the 1% of the population with a severe underlying medical condition such as metastatic cancer to the bone or bone infection (osteomyelitis). If you have any of the following symptoms, you should seek medical evaluation as soon as possible.
Red Flag Symptoms
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- Inability to control your bowel or bladder
- Numbness or tingling in one or both legs
- Pain that started after trauma, such as a fall or car accident
- Intense, constant pain that becomes worse with rest or sleep
- Unexplained weight loss
- Pain associated with a throbbing sensation in your abdomen
- Pain that is also associated with a fever, night sweats, or chills
- Numbness in both thighs
- New or progressive weakness in the arms or legs
If any of the previous scenarios describe you, please contact a medical doctor as soon as possible.