If you have a new type of low back pain; if the frequency is increasing; if the pain is more intense than usual, resulting in numbness, tingling, or weakness down the leg or in the foot; or if you experience changes in bowel or bladder habits, seek immediate medical attention! It could be a sign of a more serious condition.
Seek immediate medical attention if you have any of these symptoms:
1. Low back pain with radiation down your thigh or leg or in your foot. This can be a sign of a disc herniation in your low back. Disc herniations can be treated with chiropractic manipulation and mechanical traction, but if the herniation is grossly impinging the nerve (that is to say, pinching the nerve hard enough to lead to permanent nerve damage if it is not released in a timely manner), you may need a more immediate release of pressure on the nerve, which requires surgery.
Always get more than one opinion from at least two types of health practitioners. Too often I have had patients who were told by a surgeon that they absolutely needed surgery; however, after seeing me for a few weeks, they were able to cancel their surgery because they were so much better.
2. Low back pain that persists for more than four to six weeks (preferably you seek a healthcare practitioner’s advice within days if not hours of the onset of your low back pain, depending on the circumstances).
3. Low back pain after injury, trauma, or an accident. You may need an X-ray, CT, or MRI to rule out a bone fracture or a disc herniation.
4. If you have true numbness in the perineum, genitalia, and/or anal region (the area of your body that would touch a saddle if you were sitting in one; hence the term “saddle anesthesia”). Numbness can be a sign of a serious neurological condition called cauda equina syndrome and a cue to visit the emergency department. True numbness is when you cannot feel a thing. In contrast, sometimes an area may feel slightly numb; you may have a dull feeling like there is cloth over your skin, and you can still feel someone pressing on your skin, just not as well as usual. This is more of a paresthesia, which you shouldn’t ignore. Make an appointment with your doctor to check it out.
5. If you have a loss of bowel or bladder control. This could be another sign of a serious nerve impingement. Remember, when nerves are grossly impinged, it can lead to permanent nerve damage. Nerves simply do not heal well, and if injured too much or for too long, they may not be able to fully recover or recover at all.
6. If you have a sudden or dramatic weakness in your muscles (the type of weakness where the muscles do not respond immediately or in the specific way your brain tells them to). For example, you try to walk and your foot does not lift (aka foot drop), or your grip is weak, causing you to drop items.
7. If you cannot find a position of relief. In most musculoskeletal complaints, you can usually find a position that provides relief. If you are writhing in pain, trying to find a comfortable position but simply cannot, you are likely experiencing pain in an organ (maybe a kidney stone, a stomach ulcer, or possibly a heart attack, depending where the pain is located).
8. If your low back pain is chronic, is accompanied by anxiety and fatigue, and is spread throughout your lower torso, it could be caused by compression to the blood vessels in your pelvic bowel or the branches that drain your lower extremities. Examples of such vascular compression syndromes are pelvic congestion syndrome (PCS); May-Thurner Syndrome (MTS); nutcracker syndrome (NCS), where the vein draining the left kidney is compressed; and superior mesenteric artery (SMA) syndrome, where arteries squish the upper part of the small intestine. Usually these conditions cause pelvic pain, but can also result in low back pain.
If you have any concerns about your low back pain, ask a professional’s advice. You may waste a bit of time and money if no serious issues are found, but the cost of ignoring your symptoms may be far worse because doing so may lead to an early death.
If you suffer from low back pain and know you don’t have an underlying health condition, seek the advice of a chiropractor. In my biased opinion, they are the best health practitioners to treat low back pain because they have the best tools. More on this in later chapters.
To understand your low back pain, I show you some basic anatomy in the next chapter. Then you can better understand what could be causing your low back pain. If you haven’t seen a healthcare provider, Chapter 2 will arm you with information that may be helpful when discussing your pain with your healthcare provider.