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409-833-BACK (2225)

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Houston: Galleria Area: 4141 Southwest Freeway, Suite 490, Houston, TX 77027
Houston: SE: 12835 I-45 S., Houston, TX 77034
The Woodlands: 25440 I-45 N., Suite 200, Spring, TX 77386
Beaumont: 6025 Metropolitan Dr., Suite 210, Beaumont, TX 77706
Port Arthur: 2501 Jimmy Johnson Blvd., Suite 301, Port Arthur, TX 77640

Patient's Guide for Lower Back Pain

 

How is lower back pain diagnosed?

 

  1. History

The most important aspect of evaluation of lower back pain is obtaining a good history of the nature and character of the pain, the events surrounding the pain and how this pain was addressed, managed and treated.

 


Questions asked should include:


How Long Does It Last and How Frequently Does It Happen?


The first episodes of mechanical lower back pain resolve over days. With successive episodes, the duration of pain increases to a week and then a month; episodes may be intermittent over time. The frequency of pain may follow certain activities such as sitting in a certain chair or riding to work. It may resolve after that activity is stopped.

 


Where Is It Located Exactly and Where Else Does it Radiate To?


Most lower back pain is localized in the center of the lower back above the buttocks area. It may spread down to tone leg or both; this may signify that is nerve is being pinched ir irritated by whatever is causing the back pain. At times the location of pain is harder to describe because it is referred pain coming from somewhere else. The pain can move from side to side, or up and down. All these factors should be taken into account when evaluating someone with back pain.


What Aggravates it, What Makes it Better?

Lower back pain due to mechanical causes usually gets better with rest and worse with activities. Resting enables healing. Activities that place pressure on discs will lead to compression of nerves, such as prolonged sitting, sneezing, coughing, or straining. Disc pressure is diminished when you are standing up or laying flat. When leg pain is present with standing, spinal stenosis is the most likely diagnosis. When walking for a certain distance causes leg pain (this as called claudications), it is often the result of pressure along the nerves due to a tight canal. Typically by sitting, resting and bending forward the pain decreases.
Alleviating and aggravating factors for lower back pain can vary. These may include resting, laying down, stretching or laying tin the fetal position, sleeping, taking anti-inflammatory medication or other medications such as muscle relaxers or pain medications, staying active (especially in the case of lower back pain due to arthritis), urinating or having a bowel movement, or even doing nothing, etc. These are important to find out in order to properly diagnose the cause of back pain and to figure out the correct treatment.


What is the Timing of the Pain?


Problems causing lower back pain that affect your entire body such as inflammatory arthritis are most symptomatic early in the morning and tend to get better as the day progresses. On the other hand, pain due to mechanical problems or due to problems such as cancer of the spine typically occur later in the day. When there is a tumor in the spine, the pain is worse when laying down.

 


What Is the Quality and level of the pain?


The quality and level of the pain can vary widely from person-to-person. This usually gives information regarding what is causing that pain in the lower back. The pain can be characterized as sharp, burning or stabbing or it can also be dull,  aching and not very well-defined. It is also important to be able to tell where exactly is the pain located, such as if it is located just in the middle of the lower back or if it shoots down the leg , which leg does is shoot down to and how far down does it go in the leg. Does it go all the way down to the foot or does it stop at the thigh or the calf? It is important to know these details because this will provide information as to the origin of the pain. For example if the pain is a dull ache in the lower back but it is sharp and burning in the leg, then, most likely, it is coming from a pinched nerve in the back which may be due to narrowing of the spinal canal or a herniated disc. On the other hand if the pain is sharp and stabbing in the lower back and is intermittent and is more severe when changing positions then this most likely is secondary to some type of mechanical problem in the lower back such as a spinal instability. It is important to differentiate between mechanical lower back pain and lower back pain due to a nerve problem (“electrical” lower back pain). The treatment of these two conditions can vary widely.

The character and quality of the pain can also help us identify some of the red flag conditions. If the pain is located around the flank area or around the hip areas, this may be due for example to a problem with the kidneys or a problem with the sacro-iliac joints. On the other hand if the pain comes around from the back to the front of the chest wall or the abdominal area, then this may be due to a problem higher up in the spine or a problem with the organs on the inside such as the bowel, the stomach or the esophagus (like heartburn).

All these details are important for your medical provider to be able to isolate the cause of your pain and to be able to treat it properly with the proper tools and modalities. This will be discussed in further detail in the section on treatment
.
 

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Office Locations:

Houston: Galleria Area: 4141 Southwest Freeway, Suite 490, Houston TX 77027

Houston: Southeast: 12835 Gulf Freeway, Houston, TX 77034

Beaumont: 6025 Metropolitan Dr., Suite 210, Beaumont, TX 77706

Port Arthur: 2501 Jimmy Johnson Blvd., Suite 301, Port Arthur, TX 77640

Mailing Address:
PO box 271463, Houston, TX 77277

Phone: 832-932-9300

409-833-BACK (2225)

Fax: 1-855-790-3974

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