Back pain is common and usually gets better. Assuming that your pain will get better is a reasonable first assumption, but occasionally back pain has a more malignant course.
Back Pain Can Be the Result of a Dangerous Underlying Condition
If the pain is arising from an underlying condition like cancer, infection or a serious fracture of the bone, the pain can worsen. This fear has prompted emergency room physicians to perform too many tests. Rather than benefit the population of back pain sufferers, these tests have lead to unnecessary treatments, morbidities from the treatments and unnecessary fears.
Back Pain Can Lead to Neurologic Dysfunction
At times back pain represents a process that not only causes pain, but also compromises the neurologic structures that traverse within the spinal canal. If this process is progressive or results in instability of the spine, it can result in neurologic dysfunction. As a patient, you can look for pain, numbness or weakness of your legs. You should also pay attention to your bowel/bladder function. If the legs are involved, the symptoms can be followed subjectively or the weakness can be monitored by doing a single-leg squat on each side, walking on the heels and walking on the toes. If there is a weakness in any of these maneuvers or a change in bowel/bladder function, it is reasonable to consult your doctor.
Back Pain Can Become Chronic Back Pain
A small percentage of back pain progresses to chronic back pain. As a patient, you can’t always help the way you are, but you can be responsible for what you do. Although returning to activities too early can be a problem for a few, the more significant problem is waiting too long. You would think that taking extra time to recover “more fully” would result in a better outcome, but more often than not, it is the exact opposite.
Back Pain Can Beget Back Pain
Through a phenomenon called the chameleon effect, patients sometimes take on the characteristics that their syndrome suggests. This reflects the brain-body connection and the capacity of the brain to influence the body and the body to influence the brain. Once a patient thinks of himself as a back pain patient, he begins to act like a back pain patient. This may entail avoiding physical activities, withdrawing, taking days off of work, etc. These behaviors lead to weaker back muscles and de-conditioning of the back and, in turn, more back pain. The brain affects the body and the body then reinforces what the brain is worried about. Again, the best way to avoid this is to return to activities and to think about back pain as part of life rather than an underlying injury.