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Pain into arm or leg
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The discs in the spine are really devoid of blood supply once we are in our 20s. As we age, the discs can become brittle and more prone to degeneration. Exercise is like lubricant for the discs in the spine, keeping them more pliant and resistant to herniation. Having a sedentary lifestyle and then lifting a heavy object can cause a disc to herniate. Often times, back pain without leg pain can be from a partial herniation of the disc, or an internal disc disruption.
Typically, a herniated disc in your back will radiate pain down into your leg, or pain will radiate down your arm if you have a blown disc in your neck.
When it comes to back pain, the Emergency Room is often not the best place to go. For example, the doctor in an Emergency Room will be a specialist in emergency medicine or occupational medicine. While you may get some immediate pain medication or muscle relaxers, you will likely be referred to a spine physician elsewhere for an appointment the next day. If you have back pain that is mostly in your low back, without pain radiating into an arm or leg, you would be better off calling a spine specialist office and telling them of the symptoms. Many times, especially if you are in extreme pain, the staff answering the phone at the spine doctor’s office will squeeze you into the doctor’s schedule.
A second reason to think twice about heading off to the Emergency Room for treatment of acute back pain is that your health insurance company may not pay for it because it’s not a legitimate emergency in their view. Sure, you’ll hand over your insurance card and the hospital staff will take the information down. But a month later, when your health insurance company sends you a bill for the entire Emergency Room visit, be prepared. You may have a heart attack when you see the cost of using an Emergency Room.
Four warning signs:
1. Loss of control of the bowel or bladder:
Any time you have loss of control of the bowel or bladder, you should go to an Emergency Room, or see a spine specialist the same day. This symptom represents “cauda equina syndrome” and there could be permanent neurological damage, or paralysis of your bowel and bladder muscles if you delay.
2. Foot drop, weakness in the leg:
Weakness that extends into your foot, especially if this is getting worse, might also be appropriate for a visit to the Emergency Room if you can’t break into the spine specialist’s schedule. This symptom is called “foot drop,” because it sometimes makes it difficult for you to raise your toe when you walk. Again, if you delay there could be permanent paralysis of the nerves involved and the weakness in your foot could be permanent. There are cases where people did not recognize that their leg symptoms were related to back injury and they delayed going to the doctor until too much time passed. Once they were diagnosed, it was too late to repair the damage to the nerve root and they had to live with that symptom.
3. Car accident or fall:
Generally speaking, if you fell down stairs, were in an accident, slipped, or had another traumatic event that caused back or neck pain, you should go to an Emergency Room or see a spine specialist immediately. While most simple back pain doesn’t need X-rays, when trauma is involved, the doctor will need to shoot X-rays to make sure no vertebrae were fractured.
4. Excruciating pain:
If you are in excruciating pain, and it is in the evening or on the weekend, an Emergency Room may be your only alternative for relief. You might call the Emergency Room in advance. The Emergency Room in some large hospitals can resemble a war zone. While your back pain may be excruciating, your case of acute back pain may be low on the priority list when compared to an incoming heart attack, laceration, or car wreck victim and you may have to wait hours to see the emergency physician.
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