Back pain is one of the most common problems that people experience. Outside of the common cold, it is the most common reason for missed days of work. But how do you know if your back pain is a serious condition? One easy way to answer this question is to answer two questions : 1) the location and severity of the pain and 2) your age.
Location: Lower back pain is extremely common. The L4-L5 disc, is called “the back pain disc” because it such a weak spot that frequently goes bad first. Most back pain comes from the disc simply tearing along the outside fibers, which causes the fluid inside the disc to leak out onto the nerves. This results in back pain, frequently accompanied by burning and tingling into the buttock region or hip and down the back of the leg into the calf. The severity of the pain is often the key sign for seriousness. If the pain is severe, then it may be more than just a tear. In these cases, the disc can push out and actually hit the nerve itself. An MRI is the test of choice to definitively answer the question of whether the disc is simply torn or if it has pushed out (herniated).
Age: Your age is very important. For example, if you’re over 50 you usually have begun to develop bone spurs in your spine, which can also press on the nerves. This is a natural process of the aging condition and these bone spurs are usually the main problem.
If you’re under 20, you really should not be having back pain. When back pain and sciatica symptoms do occur, it is a warning sign that something serious could be pressing on the nerves, like a disc herniation. Unlike older age groups, bone spurs are rare in younger age groups. Back and leg pain in that does not improve in a week or so, if you are under 20, usually requires an MRI to verify that there is no serious spinal nerve compression.
Lastly, there is the 30-40 year old population. If you fall into this age group, back pain is very common. This usually due to the physical exertion required for work, recreational activities and keeping up with family life. Most people in this age group do well with nonoperative treatment for their back pain and sciatica. These treatments usually include injections, physical therapy, stretching and yoga, and over the counter anti-inflammatory medications like ibuprofen or Advil.
Surgery: Surgery is usually avoidable for the vast majority of people with back pain and sciatica with the above mentioned conservative treatment options. However, sometimes the pain continues despite these treatments. In these cases, surgery may be needed to remove pressure from the sciatic nerve in the spine. New cutting edge techniques in spine surgery, known as Minimally Invasive Spine Surgery, allow you to recover faster after surgery. This type of surgery usually only requires a band aid after the surgery.