Back Pain

Back pain that prevents you from getting up, lower back discomfort after sitting for long periods, or numbness in your legs can all stem from various causes, including muscle or bone issues, nerve problems, or internal organ diseases. Don't dismiss it as "just old age" or "the usual." The first step toward improvement is to accurately identify the cause.

• Thoroughly identify the cause of back pain through interview, palpation, and X-ray examination.
• Treatment tailored to your symptoms, including pain relievers, patches, injections, and lifestyle guidance.
• Addressing a wide range of conditions such as herniated discs, spinal canal stenosis, and compression fractures.
• No appointment needed; same-day visits welcome | Open daily from 9 AM to 9 PM.

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What is back pain?

Back pain is a general term for pain or discomfort that occurs in the lumbar region (roughly from below the ribs to the buttocks). It is said that about 80% of Japanese people experience it at least once in their lifetime, making it one of the most common reasons for seeking medical attention.

About 85% of back pain causes are called "non-specific low back pain," primarily due to muscle fatigue, posture problems, and lifestyle habits, and no clear abnormalities are found in imaging tests. The remaining approximately 15% are "specific low back pain" with specific causes such as herniated disc, spinal canal stenosis, compression fracture, infection, and internal organ diseases.

It is important to note that severe diseases that should not be overlooked can be hidden within back pain. Back pain accompanied by leg numbness or paralysis, urination or defecation disorders, back pain that persists even at rest, or back pain accompanied by fever, requires urgent investigation of the cause.

⚠️ Seek medical attention early in these cases:

• Numbness, paralysis, or abnormal sensation in the legs.
• Difficulty urinating or defecating, or incontinence.
• Back pain that persists even at rest or wakes you up at night.
• Back pain accompanied by fever (possible infection or inflammatory disease).
• Rapid weight loss.
• Back pain that started after a fall or accident.
• Sudden onset of back pain in elderly individuals (possible compression fracture).
• Back pain in patients with a history of cancer treatment (possible metastasis).
• No improvement after taking painkillers.

Main Causes of Back Pain

1. Muscular/Myofascial Low Back Pain (Acute Low Back Pain / Chronic Low Back Pain)

This is the most common type of back pain. It is caused by tension or inflammation of the muscles and fascia around the lower back, often triggered by lifting heavy objects, twisting the body suddenly, or maintaining the same posture for extended periods. Acute low back pain, commonly known as "lumbago" or "slipped disc" (though often muscular), is frequently of this type, leading to sudden, severe pain that prevents movement.

Most cases improve within a few days to weeks with rest, pain relievers, and warming, but some cases can become chronic with repeated occurrences. Chronic low back pain persists for a long time (more than 3 months) and is often associated with a combination of muscle stiffness, poor posture, lack of exercise, and stress.

Main Symptoms

• Sharp pain when moving the lower back (acute low back pain)
• Dull, heavy, or tight sensation throughout the lower back
• Back pain after sitting for long periods
• Stiffness in the lower back upon waking in the morning
• Little to no leg numbness

2. Lumbar Disc Herniation

This condition occurs when the intervertebral disc (the cartilage that acts as a cushion between the vertebrae) degenerates, causing the nucleus pulposus inside to protrude. The characteristic symptoms are back pain and leg numbness/pain due to the protruding nucleus pulposus pressing on the nearby nerves.

It is common in relatively younger individuals, aged 20 to 40, and can be triggered by bending forward, lifting heavy objects, or prolonged sitting. Symptoms range from mild to severe, and in most cases, conservative treatment (rest, pain relievers, rehabilitation) leads to improvement. However, if symptoms are severe or accompanied by urinary/bowel dysfunction, surgery may be considered.

Main Symptoms

• In addition to back pain, numbness and pain radiating from the buttocks to the thigh, calf, and foot (sciatica).
• Symptoms worsen when bending forward.
• Coughing or sneezing causes an electric shock-like pain in the back and legs.
• Dull sensation in the foot or difficulty applying strength.

3. Lumbar Spinal Stenosis

This is a condition where the spinal canal, the passageway for the nerves within the spine, narrows due to aging or bone deformation, compressing the nerves. It is common in middle-aged and elderly individuals, and unlike a herniated disc, a characteristic feature is that bending forward provides relief (while arching backward worsens it).

The most distinctive symptom is called intermittent claudication, where a person experiences leg numbness and pain that forces them to stop walking, but after resting for a short while, often by bending slightly forward, the pain subsides and they can walk again. Individuals who can walk while pushing a shopping cart or can ride a bicycle but have difficulty walking otherwise may be suspected of having this condition.

Main Symptoms

• When walking, the legs become numb and walking becomes difficult; resting while bending forward allows walking to resume (intermittent claudication).
• Legs feel heavy or numb when standing for a long time.
• Bending forward provides relief; arching backward worsens symptoms.
• Numbness or weakness in both legs (or one leg).
• Urinary dysfunction or residual urine sensation may occur (in severe cases).

4. Lumbar Compression Fracture

This condition involves the collapse or fracture of a vertebra in the lower back. In elderly individuals with osteoporosis, it can occur from minor falls, sneezing, or even just lifting a heavy object. For elderly patients who experience "sudden back pain" or "a stoop in their back," it's crucial to consider a compression fracture in the diagnosis.

While X-rays can show changes in the bone, MRI is effective for determining if it is a fresh fracture. Treatment typically involves immobilization with a brace, rest, and treatment for osteoporosis. In cases of severe pain, surgery such as balloon kyphoplasty (BKP) may be considered.

Main Symptoms

• Sudden, severe back pain in an elderly person.
• Excruciating pain when getting up or turning over in bed.
• Pain when sitting up, relief when lying down.
• Increased rounding of the back (kyphosis or humpback).
• Feeling as if one has become shorter.

5. Degenerative Lumbar Spondylosis and Lumbar Spondylolisthesis

Degenerative lumbar spondylosis is back pain caused by age-related changes in the lumbar spine (formation of bone spurs and degeneration of intervertebral discs). It is common in middle-aged and older adults, characterized by chronic dullness and heaviness in the lower back, and pain when starting to move. Lumbar spondylolisthesis is a condition where an upper vertebra slips forward, causing back pain and leg numbness. Both conditions can co-occur with spinal canal stenosis.

6. Back Pain Caused by Internal Organ Diseases and Other Factors

Back pain can originate not only from the muscles, bones, and nerves of the back but also from internal organ diseases. Back pain with the following characteristics may require suspicion of an internal medical cause:

Causative Disease	Characteristics/Associated Symptoms
Kidney stones	Sudden, severe pain from the lower back to the flank (colic). Often accompanied by blood in the urine and nausea. Pain intensifies in waves.
Pyelonephritis	Fever, chills, tenderness in the lumbar region when tapped (costovertebral angle tenderness). Often accompanied by painful urination and frequent urination.
Aortic aneurysm/dissection	Sudden, excruciating pain in the lower back or back. An emergency if accompanied by abnormal blood pressure or altered consciousness.
Spinal infection (pyogenic spondylitis)	Fever, especially severe back pain at night. Does not improve with rest. Common in individuals with weakened immune systems or diabetes.
Spinal metastasis (cancer metastasis)	Severe back pain at rest or at night. Accompanied by weight loss and general malaise. Caution for individuals with a history of cancer treatment.
Gynecological diseases (e.g., endometriosis)	Back pain related to menstruation. Tends to worsen before and after menstruation.

Summary of Types and Characteristics of Back Pain

Condition	Common Age Group	Characteristic Symptoms	Leg Numbness
Muscular/Myofascial Low Back Pain (Acute Low Back Pain)	All ages	Sudden onset with movement; general back pain	Almost none
Herniated Disc	20s-40s	Worsens with bending forward; sciatica	Present (often one side)
Lumbar Spinal Stenosis	50s and older	Intermittent claudication; relief with bending forward	Present (often both sides)
Lumbar Compression Fracture	Elderly	Sudden back pain; severe pain with movement; osteoporosis	Usually none
Degenerative Lumbar Spondylosis	Middle-aged and older	Chronic dullness/heaviness in lower back; pain when starting to move	May be present

Daily Life Countermeasures for Back Pain

To improve back pain and prevent its recurrence, it is crucial to establish healthy daily habits.

Self-care in the Acute Phase (when pain is severe)

• Rest without forcing movement (however, prolonged rest can lead to muscle weakness, so it's also important to move a little within the limits of your pain).
• Cool the affected area (cooling is effective in the acute phase when inflammation is severe. For immediate acute low back pain, use cold packs or ice packs).
• Utilize over-the-counter pain relievers and patches.
• Maintain a comfortable posture (lying on your side with knees slightly bent is often comfortable).

Chronic Phase / Daily Prevention

• Strengthen core muscles (abs and back): Strengthening the muscles that support the lower back reduces strain on it.
• Be mindful of correct posture: Prolonged bending forward or slouching increases the load on the lower back.
• Bend your knees and squat when lifting heavy objects: Lifting with a bent back puts significant strain on the intervertebral discs.
• Avoid prolonged static postures: If you have desk work, stand up and stretch every 30-60 minutes.
• Address obesity: Increased weight puts more strain on the lower back.
• Make aerobic exercises like walking a habit: This is effective in preventing chronic back pain.
• Quit smoking: Smoking reduces blood flow to the intervertebral discs, increasing the risk of back pain.

Tests and Treatments at Our Clinic

Test/Procedure	Purpose/Content
Interview, palpation, neurological examination	Confirm when, where, and what movements cause pain, presence of numbness, and urination/defecation status. Also evaluate leg reflexes, muscle strength, and sensation.
X-ray examination	Check for bone deformities, fractures, lumbar slippage, and degree of osteoporosis.
Blood and urine tests	Performed when differentiation from infection, inflammation, or internal organ diseases (kidney/urinary tract) is necessary.
Prescription of pain relievers and patches	Relieve pain and inflammation with NSAIDs or acetaminophen.
Prescription of muscle relaxants	Muscle relaxants may be prescribed to ease tension in the muscles around the lower back.
Corset (lumbar support)	Used for immobilization and rest during the acute phase or after a compression fracture.
Lifestyle and posture guidance	Advice on daily posture, movements, and stretching.
Referral to a specialized hospital	Referral letters are prepared for cases requiring surgery for herniated discs, spinal canal stenosis, compression fractures, or cases requiring MRI scans to orthopedic specialized hospitals.

Since our clinic does not have MRI equipment, if an MRI examination is deemed necessary, we will refer you to an affiliated medical institution. If you experience "numbness in your legs" or "pain that does not subside even at rest," please consult us promptly.

Flow of Consultation

1. WEB reservation or direct visit
   If it is difficult to move due to acute low back pain, please call us. We will guide you through the consultation process.
2. Reception and completion of medical questionnaire
   Please fill in when, where, and when the pain occurs, presence of leg numbness, triggers such as falls, and urination/defecation status.
3. Medical examination by a doctor
   The doctor will check the range of motion of your lower back, tenderness, and neurological findings (leg reflexes, muscle strength, sensation) to determine necessary tests.
4. X-ray, blood test, urine test
   Necessary tests will be performed in-house depending on your symptoms.
5. Diagnosis, treatment, and prescription
   We will explain the cause and your current condition, and provide appropriate treatment such as pain relievers, patches, corsets, and lifestyle guidance. If referral to a specialized hospital is necessary, we will prepare a referral letter.
6. Payment and departure
   We will provide advice on precautions in daily life, an estimated time for your next visit, and home care tips.

Frequently Asked Questions

I have acute low back pain. Should I see a doctor immediately?
If the pain is so severe that you cannot move, prioritize resting at home and applying cold. If the pain is strong but there is no leg numbness or urinary/bowel dysfunction, it is often fine to visit the next day or later. However, if you have leg numbness, paralysis, or inability to urinate, please see a doctor immediately.

Is a back brace effective for back pain?
It is effective for maintaining rest during the acute phase and alleviating pain during movement. However, relying too much on a brace for a long time can weaken the muscles around the lower back, so it is important to gradually increase the time you spend without it once your symptoms have settled.

I have leg numbness. Is it a herniated disc?
Leg numbness and pain can be caused by several conditions, including herniated discs, spinal canal stenosis, and piriformis syndrome. We will examine you with X-rays and, if necessary, provide a referral to a specialized hospital for an MRI scan. We recommend consulting a doctor rather than self-diagnosing.

Should I apply heat or cold?
In the acute phase (2-3 days from onset, when inflammation is strong), cooling is more appropriate. For chronic pain or back pain due to muscle stiffness, warming often improves blood flow and provides relief. For immediate acute low back pain, a cold pack is effective; for chronic back pain, warm packs and bathing are often beneficial.

Can I get an MRI at your clinic?
Our clinic does not have MRI equipment. Therefore, if an MRI is deemed necessary for detailed evaluation of a herniated disc, spinal canal stenosis, compression fracture, or other conditions, we will provide a referral to an affiliated medical institution.

Which department should I consult?
You can consult either orthopedic surgery or internal medicine. Our clinic also provides orthopedic care, including X-ray examinations, prescriptions, and lifestyle guidance. If you are unsure whether your condition is related to an internal organ disease or a back issue, please consult us first.

Clinic Hours & Access

Item	Content
Clinic Name	Halu Clinic
Consultation Hours	Monday - Sunday　9:00 - 21:00
Closed	None (irregular holidays)
Location	1F J&MALL, 2-27-1 Kami-Jujo, Kita-ku, Tokyo 114-0034
By Train/Walk	Approx. 1-2 minutes walk from Jujo Station on the JR Saikyo Line, 1st floor of J&MALL.
By Bus	Right in front of the Kokusai Kogyo Bus "Jujo Station" bus stop.
By Car	Please use nearby coin parking lots.
Contact Us	TEL: 03-6698-2509　／　Official LINE: https://lin.ee/DRxcelo

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