Extreme back pain for 1 month

Patient

Q: My husband hurt his back almost a month ago and now is still unable to walk more than a few feet without extreme pain. He will not go to the Dr. He says it will resolve eventually. Is he permanently damaging himself? He can't walk or hardly move. It hurts in his legs mostly and his left leg is numb.

Doctor

A:   Mechanical low back pain (LBP) is the second most common reason for seeing a physician in the United States. Of the US population, 85% will experience an episode of mechanical LBP at some point during their lifetime. Fortunately, the LBP resolves for the vast majority within 2-4 weeks. Sometimes it may complicate with a sciatic nerve inflammation this seems to be the case of your husband. The suggested strategy would be: a physical therapy program aimed to: keep the weight under control, because the overweight suppose additional stress to the lumbar spine,  control the pain and the inflammatory process, relative rest, flexion and extension exercises of the spine to reduce the nerve tension, exercises that improve the muscular strength and endurance of lumbar muscles. He can keep taking anti inflammatory medication (“Motrin”, “Aleve”) and  follow these general recommendations: sleeping with a pillow between the knees while lying on one side may increase comfort, lying on his back with a pillow under the knees. If the pain persists for more than 2 months, it is strongly recommended that he gets an evaluation by a physician to rule out more serious conditions as a disc hernia.

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