Back pain occurring with fever or resulting from traumatic injury caused by a car accident, fall or sports activity, requires immediate medical attention. Back pain without fever or recent trauma should be monitored to see if it improves in two to three days.
If problems persist for an extended period of time or initial treatments do not work effectively, individuals should seek the care of a neurosurgeon or orthopedic surgeon. With extensive specialized training and experience with spinal problems, neurosurgeons and orthopedic surgeons can offer a wide array of testing and treatment options. Seeking the care of a surgeon does not mean surgery will result. In the vast majority of cases, surgery is not necessary. However, surgery may be the best or only option to treat some conditions.
A proper diagnosis is based on a full examination that includes:
- Historical review of the patient's back, neck or leg pain
- Physical exam of the patient's back
- Evaluation of the patient's range of motion
- Diagnostic tests, which may include a spine X-ray, MRI, CAT scan and myelogram (X-ray using special dye injected into the spinal sac surrounding the spinal cord and nerves)
Treatment options depend on the spinal condition, but the primary objective of treatment is to relieve inflammation and pain. In most cases, initial treatments including physical therapy, weight control, steroid injections, anti-inflammatory medicine, rehabilitation and limited activity are attempted before surgery is considered.
Most people suffering from back pain will find relief after a short period of time. If, however, initial treatment options do not relieve pain within three months, surgery may be needed.
Surgery becomes a treatment option when an individual experiences one or more of the following symptoms:
- Leg or back pain that limits normal daily activities
- Weakness in legs or feet
- Numbness in arms or legs
- Impaired bowel or bladder function
- Incapacitating pain
- Ineffective treatment
- Spinal instability
- Deteriorating quality of life