In the midst of the COVID-19 pandemic, patients have second thoughts before going out in public and seeking help for their musculoskeletal ailments. Low back pain is one of the most common symptoms for which patients seek medical evaluation. IBJI’s Dr. Mehul Garala, Physical Medicine and Rehabilitation Physician with Fellowship Training in Spine and Sports Medicine, provides his expertise on low back pain in the setting of COVID-19.
"It is said that 80% of the population will get low back pain at some point in life, and it also has a high recurrence rate. The pain does not always have to be related to physical activity, such as lifting, and can occur spontaneously, such as when waking up in the morning. Fortunately, the majority of low back pain episodes can resolve over time," says Dr. Garala, "If low back pain occurs, is tolerable, and does not lead to any considerable functional limitations, the patient may be inclined to try to manage their symptoms at home. However, there are a few situations in a non-traumatic setting that suggests that seeking evaluation is warranted."
He continues, "If the pain symptoms radiate down the leg(s) and/or are associated with numbness, tingling or leg weakness, that may be indicative of a pinched nerve (sciatica). This condition usually requires more aggressive treatment including prescription medications, physical therapy, injections and in some cases surgery.
"A patient with a history of cancer (especially breast, lung, thyroid, kidney or prostate) who develops low back pain, that is especially painful at night, should be evaluated for concern of a metastatic process involving the spine.
"A patient who is immunocompromised, develops fevers and chills, and has localized low back pain should be evaluated for a spinal infection.
"Lastly, in any patient who has low back pain, develops bowel and/or bladder incontinence, numbness in the perianal area, and leg weakness, he/she should be evaluated for cauda equina syndrome. This is a rare, but emergent condition that requires surgery.
"Patients with any concern of their low back pain should not hesitate to seek evaluation. It is always better to be reassured that there is no concerning condition. At all IBJI locations, the patient will undergo a comprehensive assessment including a physical examination, imaging studies if necessary, and the implementation of an individualized treatment plan to help on the road to recovery," advises Dr. Garala.
Mehul Garala, MD
Mehul Garala, MD, is a double board-certified, fellowship-trained physician specializing in Physical Medicine and Rehabilitation, and Sports Medicine, with special interest in non-operative spine management. He performs musculoskeletal and spine evaluations, fracture management, and administers peripheral joint as well as interventional spinal injections.
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