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Back pain: When is it time to see an orthopaedic specialist?

Thursday, January 11, 2024 11:05 AM

By Susan J. White 

Incredibly common in adults, back pain can range from mildly annoying to severe enough to limit basic movements and significantly diminish quality of life.

Back pain is a leading cause of disability and one of the most common complaints that people bring to doctors. The causes of back pain are wide ranging and it’s important to know when to take it easy and when to bring your concerns to an orthopaedic specialist.

“The most common cause of back pain is muscle strain, which is typically self-limiting and can be treated at home with rest, heat or ice and over the counter anti-inflammatory medications,” Jimmy Zhu, MD, orthopaedic surgeon with Endeavor Health Edward Hospital.

Man with back pain

Muscle strain can be quite painful, but it should get better in a week or two without medical intervention, suggested Dr. Zhu. Physical therapy can also be helpful as patients are given targeted exercises to safely strengthen their core, as well as movements to correct potential imbalances that may lead to or exacerbate back pain.

While waiting a week or two for back pain to subside generally makes sense, there are some red flags that can indicate a more serious problem and the need for a medical consultation.

Severe pain that wakes you up at night, pain combined with a fever and/or night sweats, leg pain, or numbness that limits your ability to walk even a short distance could signal a grave condition and are cause for an evaluation from a physician, said Dr. Zhu. Loss of bladder or bowel function calls for immediate intervention and patients should go to the Emergency Department, added Dr. Zhu.

Back pain that travels down into the leg can indicate spinal stenosis, a narrowing of the spinal canal that can put pressure on nerves and is quite common especially in older adults, explained Dr. Zhu. “It’s important to see a doctor as soon as you can because the longer you wait, the worse it gets and the harder it is to treat,” he added.

There are many conservative management options for spinal stenosis and generally these options would be exhausted first before considering surgical treatment. “It’s best to get in with an orthopaedic specialist to get on the right path of diagnosis and treatment and not live with chronic pain,” said Dr. Zhu.

As a spine specialist, Dr. Zhu routinely reviews the structure of the spine following imaging like X-ray or MRI with patients, explaining potential causes and solutions for back pain. “The vast majority of the time, the spine is structurally sound and there are not neurological issues,” said Dr. Zhu.

However, sometimes the spine is structurally or anatomically off, and patients can develop spondylolisthesis, where one vertebrae slips out of place and sits on top of the next vertebra.

A common cause of spondylolisthesis, especially in younger people, can be a previous fracture of the spine that never healed correctly, explained Dr. Zhu, who said sometimes people don’t even know when they’ve had a fracture.

In older people, the cause is more commonly degenerative, and worsens over time. Depending on the severity of the condition, nonsurgical treatments, including medications and steroid injections, may be effective in reducing pain.

Some back pain is preventable by maintaining a healthy weight and active lifestyle, good posture and core strength, and some genetic factors are obviously not modifiable, said Dr. Zhu. Seeing an orthopaedic specialist when back pain persists is the best way to determine the root causes and the most effective treatment.

The team of experts at Endeavor Health Orthopaedic & Spine Institute offers world-class options close by. We use innovative, minimally invasive techniques for joint replacement, complex spine surgeries, sports medicine and more, so you can get back to the activities you enjoy sooner. Learn more.

NorthShore University HealthSystem, Swedish Hospital, Northwest Community Healthcare and Edward-Elmhurst Health are now united under one name, Endeavor Health. We’re setting a new standard for healthcare that’s focused on you, because your best health is our endeavor. Learn more.