Lower back pain, whether acute or chronic, can severely impact your quality of life. The symptoms may be localised or scattered, persistent or intermittent, and sometimes they can't be traced back to a single event such as an accident. We all know to visit a doctor when there's severe pain, but how else do you know when your pain warrants medical evaluation, and what should you expect from such a visit? Read on to learn details about this.

1. Symptoms of acute or chronic back pain

The following are instances when making an appointment with your doctor for back pain is recommended:

  • If pain can be traced to a traumatic event, e.g. after a fall or accident

  • Pain that isn't resolving or dissipating, but in fact gets worse

  • Pain that interrupts sleep

  • Pain for more than a week or two, whether intermittent or persistent

  • Pain that doesn't respond to rest or pain relievers

  • Pain accompanied by numbness, abdominal pain, altered sensation in the thigh or lower torso area, tingling or weakness

You should also be more wary of back pain if you're younger than 20 years (not normal) or post-menopausal (risk for osteoporosis). In addition, if you have weakened immunity, such as HIV or cancer patients, any persistent discomfort, even without severity, should be checked.

2. Diagnostic process

Once you notice you have a back problem, you have two recourses: seeing a medical doctor or visiting a chiropractor. If you have other medical symptoms, such as bloody urine or fever, you should see a medical doctor as your pain may be a symptom of another problem. If you're otherwise healthy, a chiropractor is well-equipped to diagnose and treat your back pain.

Regardless of who you go to, accurate diagnosis will involve comprehensive review of medical history, physical examination, and imaging. This process is critical because different diagnoses are approached differently. If the medical history and physical exams are inadequate, the doctor or chiropractor will recommend imaging tests for your back. Imaging tests include the following:

  • X-ray – details bone structure and is useful for identifying fractures, tumours, and instabilities like slipped discs

  • CT scan – more detailed than X-ray, and can image particular conditions like spinal stenosis or herniated disc

  • MRI scan – provides the greatest detail of spinal discs and nerves. Can identify infections and is usually indicated when the practitioner wishes to confirm a suspected diagnosis

3. Common treatments

The results from these tests will inform your personalised treatment plan which may include physical therapy, spinal manipulation and mobilisation, and medication in any combination. Unless you have a known condition, it is customary to attempt non-invasive methods like chiropractic adjustment and physical therapy before more invasive ones like prescription-only pain relievers, steroid injections, and back surgery.

If you're above 60 years, back pain will often be related to your age, and this means it may not be completely curable. Post-menopausal women may develop similar symptoms earlier because of the strain of child-bearing as well as decreased oestrogen production after menopause.

For these patients, the aim of therapy is to strengthen your core and relieve tension in the spine and muscles, so that you're able to live with minimal pain or discomfort. However, it's likely that you'll need a long-term treatment plan, such as periodic chiropractic adjustment to improve the quality of life.