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• Highlights
• Introduction
• Causes
• Risk Factors
• Diagnosis
• Medications
• Complementary and Alternative Medicine
• Exercise and Physical Therapy
• Surgery
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• Specific Treatment for Acute Low Back Pain
• Specific Treatment for Chronic Low Back Pain
• Prognosis
• Complications
• Prevention
• Resources
• References

Back pain and sciatica

Description

An in-depth report on the causes, diagnosis, treatment, and prevention of back pain, including sciatica.

Alternative Names

Herniated disk; Sciatica

Complications

Certain warning signs should alert a patient to see a doctor immediately for low back pain. Any very severe back pain warrants attention, particularly if any of the following conditions are present:

• Being over 50
• Recent injury
• Severe pain
• Pain awakens the person at night
• Pain accompanied by fever (possible infection)
• Pain increased by lying down
• Pain unrelated to movement
• Pain lasts for a month, and is accompanied by unexplained fever or weight loss
• History or chronic use of corticosteroids
• Intravenous drug use
• History of urinary tract infection
• In children, any severe neck or back pain or pain that persists for more than 3 days

Cauda Equina Syndrome

Cauda equina syndrome is the impingement of the cauda equina (the four strands of nerves leading through the lowest part of the spine). It is an emergency condition that can cause severe complications of the bowel or bladder. Cauda equina syndrome is usually caused by massive extrusion of the disk material. It can cause permanent incontinence if not promptly treated with surgery. Symptoms of the cauda equina syndrome include:

• Dull back pain
• Weakness or numbness in the buttocks, in the area between the legs, or in the inner thigh, backs of legs, or feet. May cause difficulty in standing or stumbling.
• An inability to control urination and defecation
• Pain accompanied by fever (can indicate an infection)

• Review Date: 3/19/2007
• Reviewed By: Harvey Simon, MD, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital

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