Back pain - when you see the doctor

Definition

When you first see your health care provider for back pain, you will be asked about your back pain, including how often and when it occurs and how severe it is.

Your provider will try to determine the cause of your pain and whether it is likely to quickly get better with simple measures, such as ice, mild painkillers, physical therapy, and exercise.

Information

Questions your provider may ask include:

You will also be asked if you have other symptoms, which may point to a more serious cause. Tell your provider if you have had weight loss, fever, a change in urination or bowel habits, or a history of cancer.

Your provider will perform a physical exam to try to find the exact location of your pain, and determine how it affects your movement. Your back will be pressed on at different spots to find where it hurts. You will also be asked to:

If the pain is worse and goes down your leg when you lift your legs straight up while lying down, you may have sciatica, especially if you also feel numbness or tingling going down the same leg.

Your provider will also move your legs into different positions, including bending and straightening your knees.

A small rubber hammer is used to check your reflexes and to see if your nerves are working properly. Your provider will touch your skin in many places, using a pin, cotton swab, or feather. This reveals how well you can feel or sense things. Your provider may also scratch the bottom of your feet to see whether you have the right reflexes.

References

Dixit R. Low back pain. In: Firestein GS, Budd RC, Gabriel SE, Koretzky GA, McInnes IB, O'Dell JR, eds. Firestein & Kelley's Textbook of Rheumatology. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 50.

Qaseem A, Wilt TJ, McLean RM, Forciea MA; Clinical Guidelines Committee of the American College of Physicians. Noninvasive treatments for acute, subacute, and chronic low back pain: a clinical practice guideline from the American College of Physicians. Ann Intern Med. 2017;166(7):514-530. PMID: 28192789 pubmed.ncbi.nlm.nih.gov/28192789/.



Review Date: 8/12/2023
Reviewed By: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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