Today’s episode is entitled “Seeing a doctor for low back pain / sciatica”, and it will answer the questions: when should you consult a doctor? And when is it potentially dangerous? The main points covered are:

• Fever and low back pain / sciatica
• Tell a doctor about the trauma on your low back / sciatica
• Tingling, pins and needles
• Bowel and/or bladder problems
• History of cancer
• Go see a doctor if you have foot drop
• Night time pain
• Unexplained weight loss
• 6 weeks of low back pain / sciatica
• If you’re over 70
  
• Children with low back pain / sciatica

Fever and low back pain / sciatica

If you have a fever as well as lower back pain / sciatica, particularly if they’ve come on at the same time, you should definitely have an assessment by either a registered doctor or at least someone who specializes in lower back pain / sciatica. They could have a common cause or they could be entirely separate. It could just be coincidence, but some infections can affect the lower back and pelvic area and that could cause lower back pain. A classic one is a kidney infection. You should also be getting on antibiotics and appropriate medical care. That’s just one of the possible infections that can cause fever and lower back pain.

Tell a doctor about the trauma on your low back / sciatica

If you’ve had any significant trauma. Has the trauma been severe enough to potentially break a bone or cause serious damage to your lower back? If it’s a significant impact, it’s certainly sensible to be assessed by a doctor.

Tingling, pins, and needles

Numbness in your leg foot could indicate you have some direct irritation or compression of a nerve at the base of your spine. It’s not a medical emergency, but it’s sensible to be assessed further so a doctor can reassure you exactly what’s going on that could be causing tingling.

Bowel and/or bladder problems

You don’t want your bowel or bladder function going wrong. The nerves that go to your bowel and bladder come from the very base of the spine adjacent to the nerves that travel into your cyanotic nerve. If you have sciatica and difficulty with your waterworks (difficulty starting, stopping, or dribbling afterwards) and this is not a new thing for you, the two may not be related at all. It could just be your old problem. But if you have a recent onset of lower back pain / sciatica and a recent change in your bowel and/or bladder, it could be that the nerves at the base of the spine have been affected.  Definitely mention that to a doctor.

History of cancer

If you’ve had cancer before, particularly in the last few years, and you have an onset of pain, it’s certainly worth mentioning either to your oncologist or just a regular doctor. They will be able to reassure you whether this needs to be further assessed by the oncology department or whether it’s just not connected.

Go see a doctor if you have foot drop

If you have difficulty lifting your foot stops, and you notice you’re catching your two on curbs tripping over, or that your foot is slapping on the ground, that suggests you have a weakness in a particular muscle, in the rural leg that looks the foot top. It’s definitely worth being assessed if you developed foot drop.

Night time pain

If you have pain that is worse at night. Lots of people have pain that is worse at night, but it is not a pathological or disease process, it’s just the way it goes for some musculoskeletal lower back issues. But if you have pain that’s worse at night and you say yes to one of the other questions -problems with your bladder, recent cancer, trauma fever- flag that up to your doctor. They will determine whether you need to be further assessed or not.

Unexplained weight loss

If you’ve lost weight without intending to over the last few weeks and you have lower back pain / sciatica, flag that one up as well. It might need to be assessed further to determine what’s the cause of this weight loss and if the two are connected or not. They may not be, but in any case it’s always worth flagging it up to your doctor.

+ 6 weeks of low back pain / sciatica

Particularly if it’s not improving or it’s getting worse, if you’ve had pain for more than six weeks, definitely go and see someone to be assessed.

If you’re over 70

If you’ve never had back pain before, but after being over 70 you’ve developed it, it’s worth being assessed. It can signal something more serious underlying.

Children with low back pain / sciatica

If you have a child, particularly under the age of 10 who complains of back pain, flag that up to a doctor. The child can be assessed. Back pain is relatively rare in young children, and so it should be investigated.