“If you took 100 people off the street and gave them MRIs, a third of them — even if they had no back pain whatsoever — would have obvious structural problems,” says Dr. Charles Rosen, M.D., clinical professor of orthopedic surgery at the University of California, Irvine, School of Medicine.
In recent years, surgical procedures like discectomy (and laminectomy) have been described as simple, one hour outpatient procedures with a ‘let’s give it a try’ attitude – as if one was getting their wisdom teeth taken out. Back pain being as nebulous as it is in Western society, can lead doctor’s to suggest surgical options without the proof of an underlying condition. However, as Dr. Aaron Filler reveals in his insightful book Do You Really Need Back Surgery, “Amazingly, 10 to 20 million times a year in the United States, this sort of low back pain happens to someone and then, a few days later, it disappears without a trace. In many cases, it either never returns or doesn’t happen again for many years. You usually don’t need to do anything to make it go away except wait”.
After reading a dizzyingly amount of opinions, people are still left wondering – Should I have surgery for a herniated disc? Well, from personal experience, I can tell you that when you’re in the Emergency Room, doctors will look for some of these signs to determine the severity of your injury, and if surgery is required.
- Foot Drop: FT can signify a serious neurological issue and as Spine-Health.com states:
Foot drop is a term that refers to a weakening of the muscles that allow for flexing of the ankle and toes. This condition causes the individual to drag the front of the foot while walking. To compensate for this dragging, the patient will bend the knee to lift the foot higher than in a normal stride (high steppage gait).
Foot drop typically affects the muscles responsible for moving the ankle and foot upward, specifically the anterior tibialis, extensor halluces longus, and extensor digitorum longus.
A quick test for foot drop is to try to walk on the heels. If this is difficult, foot drop may be present.
- Incontinence: If you have trouble urinating, could signal a spine injury. The National Assoc for Continence explains:
A spinal cord injury may interrupt communication between the nerves in the spinal cord that control bladder and bowel function and the brain, causing incontinence. This results in bladder or bowel dysfunction that is termed “neurogenic bladder” or “neurogenic bowel.”If you have a spinal cord injury, look for these signs of a neurogenic bladder:
Loss of bladder control (urinary incontinence)
Inability to empty the bladder
Urinary tract infections
- Leg Weakness: Severe leg weakness can also be a sign that there’s an underlying condition that may require immediate attention. Emedicinehealth.com points out the in some cases Spondylolisthesis may be the root cause of leg weakness:
Spondylolisthesis is a condition in which one bone in your back (vertebra) slides forward over the bone below it. It most often occurs in the lower spine (lumbosacral area). In some cases, this may lead to your spinal cord or nerve roots being squeezed. This can cause back pain and numbness or weakness in one or both legs.
Sometimes when a vertebra slips out of place, you may have no symptoms at all or no symptoms until years later. Then, you may have pain in your low back or buttock. Muscles in your leg may feel tight or weak. You may even limp.
- Other Signs include fever, weight loss and abdominal pain.
Back pain can sideline even the strongest and sturdiest and with little warning. A simple twist or tweak of the spine and you could be down for days or longer. It’s important to note though, that if your pain continues (or even increases) for more than a week, it’s probably time for a medical opinion. I’ll leave you with an interview with Dr. Russel DeMicco who gives us some additional information on how a seemingly innocuous back strain could indicate something more serious.