The great author Iain Banks died in 2013 as a result of gall bladder cancer; his first symptom was back pain. So, should all sufferers of lower back pain / sciatica rush off to the doc to get the once over just in case? I can hear all the family doctors out there shouting “Noooooooooooo……” Lower back pain in particular is one of the 3 most common symptoms GPs see anyway; they don’t want thousands more pouring through the door – unless of course you do have something more worrying. So, how could you know? What are the signs that you should look out for?
I’d like to preface the below by saying diagnosis is not an exact science, and (here it comes….) if you suffer lower back pain or sciatica for more than a couple of weeks then consult a healthcare professional.
Sudden unexplained weight loss
The key word here is “unexplained” – if you’ve been to weightwatchers and radically cutback on calories and/or massively increased your exercise regime that more than likely accounts for your weight loss. However, if you don’t understand why you’re losing weight (especially if it’s combined with feeling ill in any way, or any of the below), get along to the doc’s.
Night pain worse than day pain
It’s very common to feel at your worst first thing in the morning, but if you have a deep nagging pain that seems to be worse at night than during the day, get it checked out.
Diagnosis of Cancer
If you’ve had a cancer diagnosis, it’s possible for some cancers to spread and can ultimately cause pain in sites remote from the original cancer. So if you have persistent pain and a history of cancer, ask your doc.
Recent back surgery
This may seem like stating the obvious, but it’s worth saying. If you’ve had back surgery in the last 2 years (for whatever reason), and your pain returns/worsens, give the surgeon a ring.
Saddle numbness / pins and needles
Imagine the area up between your legs that would be in contact with a saddle (on a horse!); do you have any numbness or pins and needles there? Some people notice this when wiping themselves sitting on the toilet. If you’ve got this symptom, off to the doc again!
Loss of sexual function (I know – could it get any worse!?)
Any difficulty “getting it up” (that’s a male symptom, not an interaction); lack of feeling; or inability to orgasm (in those that can normally). Your doctor is very used to discussing these symptoms and will be understanding.
Difficulty with waterworks or Bowels
This is a very British phrase. Essentially, do you have any problems urinating or defaecating (“defecating” in North America)?
Weakness in big toe or calf
If you have any discernible weakness in attempting to lift up your big toe, or difficulty standing on tip-toes (due to weakness), get it checked out. You can test this by standing up and trying to lift your big toes up while keeping the rest of the foot in contact with the ground (don’t worry if the other toes come up with the big toe, so long as the big toes come up). Try going up on your tiptoes one foot at a time (hold onto something/someone to avoid falling). Any difference between legs?
Any big physical traumas
It’s amazing what people don’t think significant, or don’t remember. If you’ve had any big trauma to your back or just generally (e.g. car accident), it’s possible to seriously damage the structure of the spine. If you have pain AND any of the above problems after a trauma, then definitely get checked out.
Steroid use
If you’ve had months of oral (by mouth) or injectable steroids at any time in your life, flag this up to your doctor along with your back pain.
High Temperature
If you’ve got a high temperature and back pain, then this is also a sign worth following up on.
Summary
How worried should you be if you have lower back pain or sciatica? If you don’t have any of the above, not very (we can help). However, as I said above, if your pain has lasted more than a couple of weeks (even in the absence of any of the above), it’s worth getting checked out. The single biggest predictor of future lower back pain or sciatica is past episodes of it, so don’t ignore it. We can help minimise the risk of recurrence, so give us a ring or email me