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Low back pain can incorporate a wide variety of symptoms. Symptoms can be mild to severe and nearly debilitating. Low back pain may start suddenly, or it could start and gradually get worse over time.

Depending on the underlying cause of the pain, symptoms can be experienced in a variety of ways. For example:

Pain that is dull or achy, contained to the low back

Stinging, burning pain that moves from the low back to the backs of the thighs, sometimes into the lower legs or feet; can include numbness or tingling (sciatica)

Muscle spasms and tightness in the low back, pelvis, and hips

Pain that worsens after prolonged sitting or standing

Difficulty standing up straight, walking, or going from standing to sitting

Acute pain. This type of pain typically comes on suddenly and lasts for a few days or weeks, and is considered a normal response of the body to injury or tissue damage. The pain gradually subsides as the body heals.

Subacute low back pain. Lasting between 6 weeks and 3 months, this type of pain is usually mechanical in nature (such as a muscle strain or joint pain) but is prolonged. At this point, a medical workup may be considered, and is advisable if the pain is severe and limits one’s ability to participate in activities of daily living, sleeping, and working.

Chronic back pain. Usually defined as lower back pain that lasts over 3 months, this type of pain is usually severe, does not respond to initial treatments, and requires a thorough medical workup to determine the exact source of the pain. – resource spine health

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Neck pain may be sharp and located in one spot, or it might feel less intense but spread across a broader region. Sometimes the pain gets referred up to the head or accompanies a headache. Other times it can be accompanied by muscle spasms in the neck, upper back, or around the shoulder blade. Less commonly, shock-like pain or tingling may radiate down into the shoulder, arm, and/or hand.

If the pain caused by shingles continues after the bout of shingles is over, it is known as post-herpetic neuralgia (PHN). It is estimated that about 1 in 5 Trusted Source patients with shingles will go on to have PHN.

Neuralgia is neuropathic pain that occurs along the course of a nerve. It tends to happen when an irritation or damage to a nerve alters its neurological structure or function.

The sensation may be of intense burning or stabbing, and it may feel as if it is shooting along the course of the affected nerve.

Neuropathic pain comes from inside the nervous system. It is not caused by an outside stimulus, such as an injury. People often refer to it as a pinched nerve, or trapped nerve. The nerve itself sends pain messages because it is either faulty or irritated. Symptoms are usually limited to the area of skin where the shingles outbreak first occurred and may include occasional sharp burning, shooting, jabbing pain, constant burning, throbbing, or aching pain, extreme sensitivity to touch, extreme sensitivity to temperature change, itching, numbness, headaches

In rare cases, if the nerve also controls muscle movement, there may be muscle weakness or paralysis. Symptoms may make it hard to carry out some daily activities, such as bathing or dressing. PHN may also cause fatigue and sleeping difficulties.

The symptoms of sciatica are commonly felt along the path of the large sciatic nerve. Sciatica is often characterized by one or more of the following features:

Pain. Sciatica pain is typically felt like a constant burning sensation or a shooting pain starting in the lower back or buttock and radiating down the front or back of the thigh and leg and/or feet.

Numbness. Sciatica pain may be accompanied by numbness in the back of the leg. Sometimes, tingling and/or weakness may also be present.

One-sided symptoms. Sciatica typically affects one leg. The condition often results in a feeling of heaviness in the affected leg.1 Rarely, both legs may be affected together.

Posture induced symptoms. Sciatica symptoms may feel worse while sitting, trying to stand up, bending the spine forward, twisting the spine, lying down, and/or while coughing. The symptoms may be relieved by walking or applying a heat pack over the rear pelvic region.

It is important to note that any type of lower back pain or radiating leg pain is not sciatica. Sciatica is specific to pain that originates from the sciatic nerve. – resource spine health

Spinal structures and nerves are in proximity, creating the potential for irritation and pressure on the nerves. Many structures in the spine can cause back pain, such as when:

Large nerve roots that go to the legs and arms are irritated

Smaller nerves that innervate the spine are irritated

One common example of nerve pain occurs when a person has a lumbar herniated disc. The discs between the vertebrae can herniate and press against a nearby spinal nerve root. Leakage of the gel-like material inside the disc may also aggravate a nerve.

After the nerves are damaged and neuropathy develops, abnormal signals from the peripheral nervous system and the central nervous system prevent the pain from easing. – resource spine health

In clinical studies, BOTOX injections were shown to be a safe and effective treatment for those who have 15 or more days of headaches each month, and whose headaches last for at least 4 hours. BOTOX treatment reduced the number of days that study participants experienced headaches by as many as 9 days a month (compared to those who took a placebo). Migraines that do develop are often less severe than those experienced prior to BOTOX treatment.

BOTOX injections may be a successful treatment for chronic migraine sufferers whose headaches have not responded well to, or who have experienced rebound headaches from, other migraine medications. BOTOX injections are given in a doctor’s office. Premeasured amounts of BOTOX Cosmetic are injected in several precise locations around the patient’s head and neck. Locations generally include the forehead; the left and right sides of the head (above the ears); the back of the head; the base of the head (just above the neck); and down the sides of the neck.

Evaluation and treatment: good communication between clinician and patient is critical and good documentation improves communication among clinicians about the current status of the patient’s pain and responses to the plan of care. Documentation is also used as a means of monitoring the quality of pain management within the institution. Using a numeric rating scale our physicians rate pain intensity and pain unpleasantness and use a sliding scale that allows the patient to identify small differences in intensity. Pain questionnaires typically containing verbal descriptors that help patients distinguish different kinds of pain such as pulsing, shooting, stabbing, burning, grueling, radiating, and agonizing to convey a patient’s pain response and we use a body-map diagram to pinpoint its location. After patients are finished rating their pain words, a numerical score is calculated, rating their pain on a scale from 1-10 to help our physicians determine which of our minimally invasive procedures would be the most effective i.e lumbar epidural, transforaminal, cervical epidural etc.

Continued care: Our physicians continue to evaluate patients care through post procedure follow up appointment, standard follow up appointments to document the patients pain scales. Consistently reevaluating pain levels and locations help our physicians effectively treat our patients pain level.