Low Back Pain (…or is it?)

Have you ever had leg pain and immediately blamed your lower back? Many patients (and unfortunately, many doctors) conclude such pain to be “sciatica” or a “pinched nerve.” When this diagnosis is wrong, it can lead to an inappropriate type of treatment which can delay more appropriate care, or worse, may result in death due to a missed diagnosis of a blood clot.

Here’s a news flash from September 15, 2008:

WASHINGTON - Far too many Americans are dying of dangerous blood clots that can masquerade as simple leg pain, says a major new government effort to get both patients and their doctors to recognize the emergency in time.”

“It’s a silent killer. It’s hard to diagnose,” said acting Surgeon General Dr. Steven Galson, who announced the new campaign Monday. “I don’t think most people understand that this is a serious medical problem or what can be done to prevent it.”

Blood clots make headlines when seemingly healthy people collapse after prolonged sitting, such as long airplane flights or being in similarly cramped quarters. Former Vice President Dick Cheney suffered one after a long trip in 2007. NBC correspondent David Bloom died of one in 2003 after spending days inside a tank while covering the Iraq invasion.

According to the Surgeon General’s 2008 campaign, there are about 100,000 deaths associated with blood clots each year. Risk factors include increasing age (especially over 65), recent surgery or fracture, falls, car crashes, prolonged bed rest, smoking, obesity, pregnancy, and hormone replacement drugs—including birth control pills. Other less controllable causes can include genetic conditions so it is important to tell your doctor if a relative has ever suffered a blood clot.

The Surgeon General 2008 campaign warns that people with these factors should have “a very low threshold” for calling a doctor or even going to the emergency room if they have symptoms of a clot.

Symptoms include swelling; pain, especially in the calf; or a warm spot or red or discolored skin on the leg; shortness of breath or pain when breathing deeply.