Oww, oww, oww, but will the ER help?
June 19, 2011 4:51 PM   Subscribe

Trip to ER or not? The back pain edition.

So this morning I was putting my son's shoe on and my lower back exploded in pain. I was literally crying until my husband helped hoist me into bed and I got some what horizontal. And I haven't been able to move since. Lying on my side or on my back is only moderately painful, but standing up or sitting up causes so much pain that I almost pass out and throw up every time. I got muscle relaxers, max ibuprofen, and a heating pad, none of it has made anything different. So now I'm stuck at the try to go to ER, which will be horrible in and of itself, or try to tough it out till tomorrow and go to my Dr. Obviously, going to the ER sucks, but my Dr's office is very far away from the parking lot and if nothing is better tomorrow I don't think I can walk over to there and I don't think I can even sit in a wheelchair and be pushed that far. Plus Dr. trip tomorrow means hubby has to take off work.

So I'm stuck, do I go to ER tonight with all the waiting that entails and risk just being told to take the muscle relaxers I already have, or tough it out till tomorrow and go to Dr. then. For reference, the level of pain in my back is much more than when I gave labor sans drugs a couple years ago.
posted by katers890 to Health & Fitness (25 answers total) 2 users marked this as a favorite
It's **possibly** a bad muscle spasm. See if you can get to a remedial massage therapist today. if it's anything more serious, he or she will refer you on anyway.
posted by flutable at 4:54 PM on June 19, 2011

Go to the ER. First of all, it may not be your back that's causing the pain. Second of all, if it is, they can give you a shot of Toradol or something.
posted by amro at 4:55 PM on June 19, 2011 [3 favorites]

Anecdotally, I thought I had terrible back pain once and it was a kidney stone.
posted by amro at 4:55 PM on June 19, 2011 [2 favorites]

IANAD, but I would personally get away from the heating pad immediately and switch to ice; heat can exacerbate inflammation right after an injury, whereas ice is more likely to reduce it.

If the pain is worse than labor, though, I would get to an ER -- sudden, severe, intense pain that makes you throw up is nothing to be taken lightly. At the very least, they can give you a shot of something to help get you through to the next morning.
posted by scody at 4:58 PM on June 19, 2011 [4 favorites]

My back spasmed a couple weeks ago in the same place, but not this bad and it got better (mild pain in same place over the past couple weeks) but this is just beyond anything. It's definitely lower than kidneys though.

Also, started with ice, didn't do anything either, switched to heat per doc over the phone who prescribed muscle relaxers.
posted by katers890 at 5:01 PM on June 19, 2011

When I had bad lower back muscle spasms, the doc told me/gave me muscle relaxants, ibuprofen, and ice - not heat.

I know the ER sucks but I would just go. This sounds excruciating. Plus, your husband won't have to take off work to take you to the doctor tomorrow, if I'm reading that right, so that's probably a plus.
posted by J. Wilson at 5:04 PM on June 19, 2011

Maybe go to the ER, but bring a blanket or towel so you can lie down while you're waiting? And be honest with the triage nurse about the pain level. You might not have to wait too long.
posted by BlahLaLa at 5:07 PM on June 19, 2011

I had a similar type of pain when I sneezed one Sunday afternoon. I tried everything and suffered all through the night. The next morning when I called my doctor, he said to go straight to the ER.

I was wheeled into the ER where after taking x-rays of my lower back, I was diagnosed with severe muscle spasm of the lower back. I was given a whopping dose of a muscle relaxer by the was of injection in my hip. About 15 minutes later, the pain was much better.

I was poured into a wheelchair, my husband took me home with instructions not to leave me alone for the next 12 hours.

Having been though labor twice, this was 20 times more painful. Get to the ER!
posted by JujuB at 5:08 PM on June 19, 2011

was = way
posted by JujuB at 5:10 PM on June 19, 2011

Kidney stones hurt when they pass down the ureter between the kidney and bladder. The sudden pain you're describing is how it feels. Does your pee look darker at all?
posted by PSB at 5:35 PM on June 19, 2011

Just to paint a full picture, I suffered a similar episode years ago and went to the ER (well, I couldn't get up off the floor, so I actually called an ambulance). The ER did, well, nothing. They let me lay on the gurney for awhile, then sent me home and told me to take some Aleve. No X-ray, no muscle relaxant, nothing. I've since decided that they thought I was drug-seeking.

In my case, a week on the couch and I was better.

All that said, I would still go to (a different) ER if it happened again. I think you should go. The vomiting is bothersome, unless you normally react that way to pain. Also, it hopefully means that your husband does not have to take off work tomorrow.
posted by cabingirl at 5:39 PM on June 19, 2011

I did this last winter putting on a damn slipper, of all things. Agreed to go to the hospital once I realized that it was a 30-minute production to go pee.

Turned out I had a sprained back with muscle spasms. They could determine this just by feeling me up (which made me swear impressively), it didn't involve any x-rays. When the examining emergency-room doctor looks genuinely sorry and says "It is going to suck to be you for a while," you know you're in trouble.

I got a shot of muscle relaxer, some sort of pill, and I was shipped home with a pair of prescriptions that, upon taking them, made me lose two days. I was sore and stiff for a few weeks after.

So, yes. Go to the hospital. They can make it alllll go away. And if you have to attend a wedding the following weekend, they are are way better when you're high as a kite on prescription medication. Trust me.
posted by cmyk at 5:54 PM on June 19, 2011 [1 favorite]

My back spasmed a couple weeks ago in the same place, but not this bad and it got better

No, it did NOT get better. When you hurt your back, you have to take it really easy, really consistently, for quite a while. I'm no expert, but as a back pain sufferer I say forget the ER and just lay there for a day or so and see if anything abates.
posted by hermitosis at 5:57 PM on June 19, 2011 [4 favorites]

This happens to me every couple of years. I've gone to the ER before, and they have not been helpful. The ER is also expensive and a uniformly unpleasant experience. So, if you can tough it out through tonight, I'd wait and see how you're doing tomorrow morning. If you don't feel like you can get to your regular doctor, you could at least try to find an Urgent Care that is more accessible. The cost and wait time will almost definitely be far less than the ER.

Anyway, though, the only thing that ever helps me is time - taking a couple days off from work and staying as motionless as possible. And lots of ibuprofen.
posted by something something at 6:10 PM on June 19, 2011

Oh, one other thing - depending on how well your doctor knows you, you may be able to get him or her to call in a muscle relaxant without you going into the office. Mine was very accommodating the last time I went through this.
posted by something something at 6:12 PM on June 19, 2011

This may sound heartless, sorry. And I have had very successful back surgery. If you go to the ER it is going to cost some one $1000s of dollars and possibly you $100s. It is inconvenient and you may or may not get symptomatic relief. In the absence of any other symptoms, assuming this was an acute onset related to bending/stretching and vomiting/nausea is not atypical for you consider staying home for 36 hours. Do not use heat for 24 hours, alternate favored NSAID with acetaminophen (see schedules on internet, under dental pain relief) keep moving gently limited by pain (to tolerance), and your knees bent while resting. If possible give it 24 hours. Call Dr and schedule appt. for 36 hrs and check if they will prescribe non narcotic pain reliever over phone. If you do go to ER don't second guess yourself and I hope it helps. IANAD but you asked the question. BTW, if you have radiating leg pain and change in strength and/or sensation in legs--go to ER.
posted by rmhsinc at 6:29 PM on June 19, 2011

i had at least the same level of pain that you are describing when i herniated a disc in march. it was unbearable to walk to the bathroom, let alone sit on the toilet. laying flat was the only way to do anything. heat made everything worse. i am certainly not saying you have a disc problem, just saying i understand the pain level.

do you have to be mobile to take care of your son? if you have to do that, you may consider going just to see if they can give you something that will more immediately help (i.e. a shot of something). if you can rest and wait for a minute, do that. if it isn't on the path to getting better within a day, go to a doctor. i wish that i had gone to a doctor sooner instead of laying on my back for most of a week.

hope it feels better! and fast!
posted by itsacover at 7:17 PM on June 19, 2011

I had a particularly bad back pain once when I took my kid to the Dr, I mentioned it, he asked if I had a fever, when I said no, he then leaned toward muscle sprain. Don't know how fever connects to serious back issues myself though. IANAD.
posted by lundman at 7:39 PM on June 19, 2011

Don't let the distance from your doctor's office to the parking lot dissuade you. Get soneone to drive you straight to a handicap spot or loading zone at the entrance. Leave a note visible to potential ticketers and ask the front desk for a more official note.
posted by zippy at 7:39 PM on June 19, 2011

This happened to me (sitting at my desk, reaching for the phone!). What helped for me was ice directly on the hurty part to reduce the inflammation, about 20 minutes at a time, then give yourself another 20 minutes before reapplying to avoid a cold injury, but a heating pad under my butt to relax the muscles. Lie down with a pillow or two under your knees and see if that helps.

Aleve and ibuprofen will help you a lot. You can take up to four ibuprofen at a time (take it with food, and you might also want to take Pepcid twice a day while you're doing this to protect your stomach). Take it every four to six hours, whether you think you need it or not. In a day or so you'll "get ahead" of the pain. (And if it isn't diminished by then, you KNOW you need more ammo.)

In the meantime, call your doctor tomorrow morning and explain what's happened. Doctors always keep appointments open for urgent cases like this, so they should be able to see you.

If you find that your crotch starts to go numb or that you're having trouble with bowel or bladder control, go to the ER because the swelling has started to compress your spine. But in the absence of that, try to tough it out at home till morning.

I'm so sorry. I know what it feels like. You'll be off your feet for a few days at least, I think, and moving slowly for another week or two.
posted by thinkingwoman at 7:58 PM on June 19, 2011

I threw out my back picking up my son just over a year ago, which I posted on the green here. I swear the pain was excruciating and I could barely move. I managed to get to a doctor the next day and he prescribed muscle relaxers and pain killers, which I never took. I had a vacation the next week and healed enough to travel just fine.

I did not go to the ER and gutted through the pain. It was awful, but it passed. An ER visit seems pretty extreme to me.
posted by murrey at 8:05 PM on June 19, 2011


And my previous answer as well:
Try an Urgent Care (aka "Doc in the Box," in my family at least) facility rather than the ER. You don't need an appointment as you would with your normal doctor, and it won't have the insane expense or (usually) insane wait of an ER. I had something similar happen over Christmas this past year and the doctor gave me a shot of something that seemed to loosen up the muscles in back so I wasn't in such agony. (Also a prescription for muscle relaxers and pain killers and big numbing patches.) Ultimately, it took several weeks of rest, but whatever that shot was helped. Unfortunately, I was in such agony that I don't know for sure what it was, but it looks like it may have been a cortisone shot.
posted by wuzandfuzz at 8:16 PM on June 19, 2011

The ER exists to make sure you survive until the docs do their rounds in the morning. Can you survive until morning? Good. Save yourself (or your insurer) $2000 or so and just schedule an urgent care visit tomorrow.
posted by mmdei at 9:02 PM on June 19, 2011 [1 favorite]

I like what mmdei said. You could probably get some fab pain meds in the ER tonight, and maybe get an X Ray or MRI, but that all depends on staffing, speed, and number of patients they have. I'd say that if you can somehow make it through the night tonight, go to an orthopedist tomorrow (if you can....if not see if a family doc can get you some X Rays or evaluated by someone) first thing.

I haven't had this experience myself, but my grandmother did back in December. Turns out she had ruptured a disc, just by turning to leave the bathroom. Apparently there was already some damage there and the slight twist she did while turning was all it needed to pop. I'm not diagnosing you here, just saying that it could be more than a spasm. Grandmother thought she had broken her hip because she couldn't walk and she had pain shooting down her leg. After laying still most of the day we finally called an ambulance to take her to the ER (she's 94...we could not have transported her ourselves). YMMV obviously.

I hope it's nothing major, and that you feel better soon!
posted by MultiFaceted at 10:03 PM on June 19, 2011

I gave up and went to the ER, I almost passed out a bunch getting there, and finally got into a room where they shot up with with 5 different meds, including a double dose of narcotics (the first didn't take) before I could get out of bed at all. They were pretty sure that it was just spasm, but they were entertaining the idea of some disc problem. And then I went home and crashed, slept till like 9am and actually managed to get out of bed by myself this morning, so a win for me I think. Thankfully my insurance is fantastic so it only costs me like $40 to go to the ER, and we got to mock the belligerent drug seeker across the way while I waited (the nurse and doctor loved us in comparison), and I didn't have to figure out how to get across an entire hospital to see my doctor, so I think it was a wing in the end to go to the ER.

Thanks for all the advice.
posted by katers890 at 8:24 AM on June 20, 2011 [1 favorite]

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