My husband hurt his back a while ago. The doctor assured us it would resolve itself in a couple of weeks. Well it didn't, and now he's depressed and withdrawn, losing sleep, and may lose his job over it. What do we do now?
Acute low back pain is common in all ages from young to older adults. In fact, it's estimated that if a poll was taken on any given day, 20 per cent of the American population would say they were having back pain that day. It's true that the majority (80 per cent or more) of individuals experiencing a bout of back pain will get better. Usually the symptoms resolve (go away) gradually over a period of 10 days to two weeks. Occasionally, painful symptoms may linger for three or four weeks. But when they don't go away, and the person's function (mental or physical) is impaired, it's time to see the doctor. A careful medical exam is warranted. This is true even if the patient saw the doctor at the beginning of the problem. With time, things may have changed from what the doctor saw on the first day. Sometimes this is referred to as progression of disease or progression of clinical presentation. Your husband may have progressed from an acute to a chronic stage of back pain. This occurs in about five to 10 per cent of patients who experience some form of acute low back pain. If it's pain of a mechanical nature (involving the alignment and movement of bone or soft tissues), then it may be time to see a physical therapist. The therapist will evaluate posture, musculoskeletal alignment, and movement and formulate a plan of care. This may include manual therapy (a hands on approach to restore tissues to their normal state) and prescriptive exercises. If it's not mechanical, then the physician will look for a potentially more serious problem such as fracture, infection, or tumor. The extent of the investigation will depend on the physician's interview with the patient. The doctor takes into consideration the patient's personal and family history, clinical presentation, and any red flag associated signs and symptoms. At that point, additional clinical tests, lab values, and imaging studies may be ordered.