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COPYRIGHT 2006 Copyright by President and Fellows of Harvard College. All Rights Reserved
About three of every four men have endured a bout of low back pain, and many have had repeated episodes. The pain may begin gradually or suddenly; it may be mild or severe. In most cases, doctors cannot pinpoint the cause of the pain, and in most cases x-rays and blood tests are useless. In fact, even advanced imaging techniques such as MRIs and CTs are not recommended for typical patients.
Most people with low back pain can handle the problem themselves, sometimes with the aid of a phone call or visit to their doctor and the short-term use of simple medications. But there are exceptions; the list below details situations that call for prompt medical attention.
Warning signs: When to worry about your back
First episode before age 20 or after 55
Recent major trauma, including motor vehicle accidents, falls, and severe sports injuries
Radiation of pain down a leg, particularly if accompanied by:
Numbness or loss of sensation
Weakness or loss of muscular strength
Impaired bowel or bladder control
Constant pain that is not affected by motion
Pain in the upper back or chest
Pain that increases at night or when lying down
Unexplained weight loss of 10 pounds or more
Unexplained fever
A previous diagnosis of cancer
Use of corticosteroids or other immunosuppressive drugs
History of drug abuse
History of a major chronic medical illness
If you have one of the warning symptoms in the list, consult your doctor. But if you have garden-variety pain, you may well be able to take care of it yourself -- and you certainly should take steps to keep your back in shape.
What to do
Until recently, doctors recommended elaborate programs of bed rest, traction, or therapeutic exercises for acute low back pain. Not anymore. Careful studies show that none of these programs help. The best plan is to return to normal activities as soon as you can. Don't try to...
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