If eighty percent of back pain goes away on its own over a month or so, when do you need the help of a doctor?

While most people cannot reliably diagnose their own internal medicine or heart problems, a sore back is self-apparent. You may be interested to learn, however, that pain is a poor indicator of what is wrong with your back. A muscle strain, for example, can be more painful than a herniated disc.

Generally speaking, if you have any of the symptoms listed below, or if you have back pain that doesn't go away on its own after about three or four weeks, you may want to visit a spine physician to rule out anything serious.

A back specialist who examines you will be looking for telltale symptoms that might suggest that a disc is affected. Pain that radiates from the back down into your leg, even into the bottom part of the leg, can mean there is a disc problem.

When should you go to the Emergency Room?

When it comes to back pain, an emergency room is often not the best place to go. For one thing, the doctor in an emergency room is usually a specialist in emergency medicine or occupational medicine. While you may get some immediate pain medication or muscle relaxants, you will probably be referred to a spine physician elsewhere for an appointment the next day. If you have back pain that is mostly in your lower back, without pain radiating into an arm or leg, it would be better to call a spine specialist's office and tell them about the symptoms. Many times, especially if you are in extreme pain, the staff answering the phone at the spine doctor's office will squeeze you into the doctor's schedule.

Another reason to think twice about heading off to an emergency room for treatment of acute back pain is that your health insurance company may not pay for it because it is not a legitimate emergency in their view. Sure, you'll hand over your insurance card and the hospital staff will take the information down. But a month later, when your health insurance company sends you a bill for the entire emergency room visit, be prepared. You may just have a heart attack when you see the cost of going there!

DO Go to an Emergency Room If You Have These Warning Signs!

• Loss of control of the bowel or bladder
• Any time you have loss of control of the bowel or bladder, you should go to an Emergency Room or see a spine specialist the same day. This symptom represents cauda equina syndrome, and there could be permanent neurological damage, or paralysis of your bowel and bladder muscles if you delay.
• Foot drop, weakness in the leg
• Weakness that extends into your foot, especially if it is getting worse, may be a symptom called "foot drop" and might call for a visit to the Emergency Room if you can't see a spine specialist's soon. If you delay there could be permanent paralysis of the nerves involved and the weakness in your foot could be permanent. There are cases where people did not recognize that their leg symptoms were related to back injury and they delayed going to the doctor until too much time had passed. Once they were diagnosed, it was too late to repair the damage to the nerve root and they had to live with it.
• Car accident or fall. Generally speaking, if you fall down stairs, are in an accident, slip or have any other traumatic event that causes back or neck pain, you should go to an emergency room or see a spine specialist immediately. While most simple back pain doesn't need x-rays, when trauma is involved the doctor will need to take x-rays to make sure no vertebrae are fractured.
• Excruciating pain. If you are in excruciating pain, and it is in the evening or on the weekend, an emergency room may be your only alternative for relief. In this case, though, you might call the ER in advance. In some large hospitals the emergency room can resemble a war zone. While your back pain may be excruciating, your case may be low on the priority list compared to an incoming heart attack, laceration or car wreck victim, and you may have to wait hours to see the emergency physician.