Should I Go to the Emergency Room with my Back Pain?
A Quick Lesson – Emergency Room or Not
At some time or other most of us will have back pain. What people need to know is what is a dangerous back pain and what is something you must just get through. I get asked many questions about this so I thought we could answer some of the most common. Please do not diagnose from these recommendations. They are just a guideline.
What should I do first after the injury?
The first thing you should do is assess what is happening to your pain. Is it a sharp or dull pain? Does it radiate anywhere? Is it constant? Does it hurt with certain movements? Is it bearable?
How do I treat the pain initially?
Acute back pain should be treated with ice and rest. 20 minutes of ice at a time is adequate and should be applied several times a day. Over the counter anti-inflammatories (if you are able to take them) should decrease the pain.
What else is happening to my body?
Do you notice any weakness or numbness and tingling? Are you able to walk? Are you having a loss of control of your bowel or bladder? Is there some type of sexual dysfunction?
Why would I go to the ER?
The above symptoms of weakness or loss of control are a reason to go to the emergency room. It generally means there is pressure on the nerves to the pelvis and lower extremities and if not dealt with quickly, can lead to permanent damage. It is called “saddle anesthesia” and is one of the first things that need to be assessed with a reported back injury.
What would they do in the ER?
After an exam, radiological studies will be performed to see what is causing the pressure on the nerves. There could be infection, a tumor, or most often with acute pain, a fracture or a herniated disc. A strong anti-inflammatory, such as an IV steroid, is given to decrease the swelling and therefore decreasing pressure on the nerves.
When is surgery necessary?
Surgery is necessary if the pressure on the nerves does not decrease with the medication, if the paresthesia continues, or if the symptoms worsen. It can be a simple discectomy or a larger decompression, depending on the problem.
If I don’t need surgery, what should I do?
Once it is considered safe, you can gradually increase your activity. Anti-inflammatories and muscle relaxers make movement easier. Time stretching, and in physical therapy, can be beneficial for the pain right now and to prevent future exacerbations.
- Chenot JF. [Low back pain: focused history taking and physical examination]. Dtsch Med Wochenschr. 2018 Oct;143(21):1556-1563. PubMed PMID: 30336508