Low back pain

At one time or another, all of us will likely have low back pain. It will interfere with work, daily routines and recreational activities. In fact, back pain is the second most common cause of a visit to the doctor's office.

Dr. Stephen Reed and Penny Kendall-Reed, co-authors of The Complete Doctor's Healthy Back Bible, joined Balance television host Dr. Marla Shapiro to talk about some of the causes of back pain.

"Acute back pain is really just back pain which only lasts for about 4-6 weeks," Kendall-Reed said. "Once it starts to go beyond that, we can take a look at categorizing it, either into recurrent pain -- if you're getting more and more episodes of it with intermittent periods of no back pain -- or into chronic back pain which is basically just a back pain which lasts 12 weeks or more on a continual basis."

Most of the time low back pain can be traced back to an event such as shifting some boxes, gardening, or performing other activity the individual isn't used to doing, Reed explained. Often, the acute back pain won't manifest itself right away but the person wakes up the next day in terrible pain.

But why do we get that pain? What's happening in our bodies?

"There are a number of causes that are considered. A specific diagnosis or location of damage is often not found," Reed said. "However, what we're assuming is happening is that a small injury to the muscle, a small muscle tear that doesn't hurt too much to start with, over 24-48 hours you get inflammation and some bleeding. And it's that inflammation causing aggravation and sensitization of the local nerves in the back that actually result in a marked increase in pain."

The Reeds stressed the importance of being able to use words to describe your pain to your doctor.

"There's a lot of different things we want to look at," Kendall-Reed said. "We want to look at the quality of the pain and the severity of the pain and the type."

"Is your pain actually radiating down the leg or is just it localized around the back? Because that would be indicative of different types of injuries," she said. "Is it more of a low back pain or is it a disc injury? Or is it actually a leg pain? We also want to look at: is it throbbing, is it intense, is it stabbing?"

The different words can give a doctor clues to the pain's location and what sort of treatment to pursue. If it's a throbbing pain it's generally muscular and if it's intense and pinpoint it may involve the nerves, Kendall-Reed said.

So who's at risk? According to Reed, everybody, to a certain extent.

He did say that someone who's relatively unfit and doesn't stretch or exercise, and decides to do some heavy lifting or moving, is at a high risk.

Back Pain Red Flags

• Significant injury
• Severe, unremitting night pain
• Fever
• History of cancer
• Rapid and unexplained weight loss
• History of osteoporosis or steroid medication
• Symptoms of cauda equina syndrome (loss of bladder or bowel control)

Again, a reminder that most acute back pain will resolve itself in 4-6 weeks. But the red flags are signs of far more serious conditions that a physician should take a look at right away.

The cauda equine syndrome is one of the rare emergencies in the field of back surgery, Reed explained. It involves an acute and aggressive compression of the nerve roots in the spinal canal. Besides a loss of bladder and bowel control, other symptoms include a progressive weakness and loss of feeling in the legs, particularly in the saddle area between the legs. This needs to be addressed on an emergency basis.