When I was in my early 20’s I had pushed my broken down full sized pick up truck a block to where it could be safely parked until I could get it taken care of. The next day, my lower back was very achy, felt just like I had pulled some muscles; made sense right? I went to my chiropractor, he checked me out, and told me to immediately see my medical doctor, that the lower back pain was not a musculoskeletal problem. My medical doctor diagnosed me with a pelvic inflammatory disease, immediately prescribed medications and gave me his home number to call. If it worsened he was going to admit me to the hospital. Until that morning I had no symptoms at all, felt completely normal. Luckily for me, my chiropractor knew the difference between a musculoskeletal problem and something more dangerous.
When I was first in practice in the early 1980’s I got a call from my 32 year old brother who was living with his wife in Saskatoon Saskatchewan Canada. He had just gotten a diagnosis of terminal kidney cancer. Months before he had gone to his primary care doctor with the complaint of lower back pain. The doctor knew that my brother did weight training and was physically active, told him that it was due to his activity levels and just take some pain medications and cut back on his activities. My brother did that, still suffering the back pain, until six months later he started passing blood. When the hospital looked, the kidney cancer had by then spread all over his body. He died 3 months later. He might have been saved with an earlier proper diagnosis.
Why do I tell you these stories? Because lower back pain is not caused by one simple thing. A short but not inclusive list of what can be causing the pain would be: muscles, joints, pinched nerves, a disc problem, arthritis, or referred pain from an internal organ like your kidneys, bowel, bladder, female organs for women or prostate for men. The story about me illustrates that the referred pain from an internal organ can feel just like pain from muscle over-use or some common problem. So, how can you tell the difference and make a wise choice?
1. If the pain is not obviously getting better in a few days… have a doctor check you out. If that doctor’s treatments are not helping after a few weeks, and you intuitively feel that maybe the diagnosis is wrong… go get looked at by a different kind of doctor.
2. Does the pain change with change of position? Internal organ pain usually will not get better or worse when you lie down, bend over, sit or walk. It can be a steady ache or a cramping pain, or a throbbing pain depending on the source of the problem.
3. Pains from muscles, joints, discs, pinched nerves tend to get worse when a movement or position works the injured part. We can usually find a “relief position” that eases the pain by taking pressure off the injured tissues. As a chiropractor, I also can usually reproduce the pain you are telling me you are having by the simple movement and palpation tests I do in my office.
4. You cannot tell what tissue is injured by the intensity of the pain. Some things are very painful but not life threatening, like a muscle spasm. Some dangerous things start out as a low level ache that most people would ignore because it does not stop them from their work or general activities. This is why, if a lower back pain is not going away and you do not have a good idea of what is causing it, that you should get it checked out.
If you are not sure what kind of doctor to see first, schedule an appointment for an exam by calling me at 978-535-6155. I can tell you if it is a type of problem that I can treat, or if you need special tests and what type of medical doctor would do those tests.