Ask the Pharmacist

Q: I was helping my daughter move her stuff for school and seem to have hurt my back. Can I just take a couple of Advil and muscle relaxants or should I see my doctor?

A: Back pain is one of the most common reasons that adults seek immediate medical attention, with research indicating that in a six-month period, 50 per cent of adult Canadians experienced some degree of back discomfort, and up to 85 per cent reporting this at least once in their lifetimes.

It can occur at any point in life but seems to be most likely between the ages of 30 and 50, and occurs in both sexes with equivalent frequency.

Our backs play a vital and supportive role, both when our bodies are at rest and at work, and with the hazards of the modern society (sedentary lifestyles, desk jobs, our tendency to carry a few extra pounds), back pain has reached epidemic levels.

While back pain is usually a result of faulty mechanics or trauma, identifying the actual cause of the pain is relatively difficult to do. In fact, in approximately 85-90 per cent of individuals with lower back pain, no apparent cause can be found.

There are times when acute medical attention is absolutely warranted and there are other times when you might spend four hours waiting in an office or emergency room only to be told to take a few Advil and apply some ice/heat. Coupled with the fact that every time you visit the emergency department, it costs all of us at least $195 (in taxpayer's money) before any treatment is done, knowing when to seek expert help is vital.

As such, the following is a list of specific symptoms or causes that would prompt us to refer someone to another health care specialist for immediate assessment.

We cannot recollect seeing this before in our practice, but the simultaneous presence of a fever (often unresponsive to fever-reducing medications) with acute back pain might be an indication of a serious infection (an infection in the spine can press on nerve structures, possibly putting you at risk for paraplegia or even quadriplegia) that will require antibiotic therapy promptly. Please note before you hit the panic button that lots of the more common flu's come with some degree of back stiffness.

The concurrent loss of bladder or bowel control usually accompanied by progressive leg weakness or numbness in the hips, crotch and/or legs, might be indicative of a rare disease known as cauda equina syndrome. This disorder can arise as a result of a herniated disc, fracture or other trauma to the spine, and require emergency surgery to rectify.

Back pain accompanied by foot drop (when your toes drag along the ground or require you to consciously lift your foot so that this does not happen), may be a sign of a nerve, muscle or brain problem that requires immediate attention as well.

One symptom that is a common complaint, is best described as “pins and needles,” “tingling” or numbness rather than just the usual symptoms of spasms, pain and tightness. These atypical symptoms are usually an indication of either nerve irritation or damage, and can be indicators of a herniated disc or spinal stenosis.

These conditions, if left unchecked, can leave you with chronic nerve pain and the possibility of a permanent disability. If you are fine during the day but the pain becomes unbearable when your head hits the pillow, that might be a sign of a degenerative disc or something even more sinister such as a tumour.

Your back pain when accompanied by unexplained and sudden weight loss, might be the result of significant disorders such as an infection or tumour.

Lastly, most benign causes of back pain (in fact greater than 90 per cent) tend to improve on their own within six weeks, if not much sooner. If your pain is still severe at that point in time, even if it is not accompanied by any other symptoms, further investigation should be initiated with your doctor.

Frequently, it’s hard to know when to take the next step and get any disorder looked into further, whether it is a sore back or runny nose for that matter. Feel free to take advantage of the available resources in your community (be it a pharmacist, friendly or not, Telehealth Ontario, or an acquaintance with the proper medical background) to get some advice on your symptoms.

For more information about this or any other health-related questions, contact the pharmacists at Gordon Pharmasave, Your Health and Wellness Destination. Also check the website at www.gordon-pharmasave.com/ and the Facebook page at www.facebook.com/GordonPharmasave/?fref=ts