Almost everyone has had back pain at some point in their life. Sports injuries, car accidents, heavy lifting, long car rides, sitting at a desk all day–there’s no shortage of causes. Most of the time, the pain is manageable; sufferers pop a few painkillers, maybe throw on some ice, and assume a little back pain’s bound to act up every now and then.
But what if it isn’t? What if, by taking those painkillers, we’re really just masking a symptom of a greater problem? Charles Gambino, D.O., of Northcoast Internal Medicine in Sea Cliff, New York, worries this might be the case.
“The risk of taking any analgesia for an extended period of time to help with back problems is covering up a potentially life-threatening problem,” he says, adding that painkillers like ibuprofen should be taken only for 48-72 hours at most. “Any recurring pain needs to be evaluated.”
This is especially true for older people, for whom non-musculoskeletal causes of back pain are much more common. According to Dr. Gambino, “In general, under the age of 50, back pain would be associated with job-related injuries, trauma, etc. and the cause would be a little bit more obvious…but as [the patients] get older, the diagnosis requires…more attention.” He estimates that, for individuals over the age of 60, pain in the back has a 50-50 chance of being caused by something unrelated to the spine or muscles.
The list of back pain culprits he’s seen is extensive: Metastatic disease, cancer, Lyme disease, infection, pneumonia, pleurisy, pulmonary issues, Pott’s disease (tuberculosis of the spine), multiple myeloma, gall bladder disease—just to name a few. Appropriate testing needs to be done to determine where the real issue lies.
Often, Gambino will send back pain patients to physical therapy when a more typical injury is suspected, in order to both ease their pain and prevent re-injury. “[Physical therapy] will handle all of the acute musculoskeletal problems, as well as the chronic,” he says. But “if [patients] undergo a course of physical therapy and they’re not getting better, then there might be something else underlying.”
Either way, by ignoring their pain or simply suppressing it with medication, people aren’t doing themselves any favors.
“Through my years of practice, I’ve noticed that back pain should not necessarily be brushed off,” Dr. Gambino insists. “It could be an indicator of something more serious.”