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When to Seek Care for Back Pain

Experiencing back pain? It’s best that you don’t delay your care.

As remote work life becomes the norm, minding your spine health is more important than ever. But what is the difference between minor aches and pains that need medical attention? To learn more, we spoke with Michael S. Yoon, MD, FACS, spine surgeon, Neurosurgery, Jefferson Health’s Vickie and Jack Farber Institute for Neuroscience.

Q: What are some indications that back pain could be a serious health issue?

Dr. Yoon: If you have severe pain that lasts for more than several days—more than just periodic lower back pain spasms—it may be cause for concern. This is especially true if you start to develop new or worsening muscle weakness or loss of bowel and bladder function. If you experience any of these symptoms, it’s important to visit the emergency room. Lingering symptoms can indicate compression of the spinal cord or nerve roots that could cause irreversible damage.

Q: How do you categorize the different types of back pain?

Dr. Yoon: Back pain is not black and white, but rather a shade of gray. It’s usually caused by a variety of factors and can appear in various forms. Mechanical pain is pain in your low back, mid back or neck that gets worse when you stand up and better when you lay down. This type of pain is completely distinct from chronic, constant pain that is there all of the time. And lastly, there’s nerve-related pain, which happens as a result of compressed nerves or a compressed spinal cord.

Q: What should people with existing conditions be aware of when it comes to back pain?

Dr. Yoon: If you have a history of cancer, back pain could be a sign that your tumor has spread to the spine. Additionally, if you are immunocompromised, on medication or have underlying conditions like diabetes, you should be aware that the development of a fever along with back pain can indicate an infection.

Similarly, germs can travel into the bloodstream in or near the spine. So developing back pain while open skin sores or wounds are present can be a cause for concern.

Q: What are the treatment options for back pain?

Dr. Yoon: There are many different ways to treat back pain, depending on the patient’s symptoms, underlying conditions, lifestyle and more. In general, I make sure that patients have tried conservative measures, like physical therapy and injections, first. After conducting diagnostic imaging, like an MRI or CT scan, I’ll go through the imaging studies with the patient so they can see what’s going on with their body anatomically. This way, patients can see if the cause of their pain is a compressed nerve root or the spinal cord itself.

Surgery is an option, but it is a big step, which is why I emphasize patient participation. It’s important that patients are aware of the risks, benefits and outcomes. By using minimally invasive techniques, we can ensure that patients who undergo surgery for back pain have relatively quick recovery times, minimal pain and few complications. Minimally invasive surgeries for back pain include fusion, disc replacement, decompression and more.

Q: Do you lose mobility after neck or back surgery?

Dr. Yoon: On the contrary, surgery can help restore mobility. For example, herniated discs usually cause radicular pain—the feeling of a pinched nerve—in the back. The herniated disc, in and of itself, will result in loss of mobility because of muscle spasms. If this person has been treated conservatively but still has pain or limited mobility, that’s when we use surgery to remove the disc. Though this is a disruptive surgery, taking out the disc will relieve pain, which results in reduced inflammation and increased mobility.

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