Back Pain

Mechanical problems

Mechanical problems have to do with the way your spine moves, and can include joint breakdown, spasms, muscle tension, and ruptured/herniated discs. One of the most common mechanical causes of back pain is a condition called intervertebral disc degeneration, which means that the discs located between the vertebrae of the spine are breaking down with age, losing their cushioning ability. Another cause of back pain is the wearing down of the facet joints, which are the large joints that connect each vertebra to another.

Injuries

Spine injuries such as sprains and fractures can cause either short-lived or chronic back pain. Sprains are tears in the ligaments that support the spine, and they can occur from twisting or lifting improperly. Fractured vertebrae are often the result of osteoporosis, a condition that causes weak, porous bones. While osteoporosis itself is not painful, it can lead to painful fractures of the vertebrae. Less commonly, back pain may be caused by more severe injuries that result from accidents and falls.

Acquired conditions and diseases

Many medical problems can cause or contribute to back pain. They include scoliosis, which causes curvature of the spine and does not usually cause pain until mid-life; spondylolisthesis, or vertebrae displacement; various forms of arthritis; and spinal stenosis, a narrowing of the spinal column that puts pressure on the spinal cord and nerves. Other causes of back pain include pregnancy; kidney stones or infections; endometriosis, which is the buildup of uterine tissue in places outside the uterus; and fibromyalgia, which causes fatigue and widespread muscle pain.

Infections and tumors

Although they are not common causes of back pain, infections can cause pain when they involve the vertebrae, a condition called osteomyelitis, or when they involve the discs that cushion the vertebrae, which is called discitis. Tumors, too, are relatively rare causes of back pain. Occasionally, tumors begin in the back, but more often they appear in the back as a result of cancer that has spread from elsewhere in the body.

Emotional stress

In addition, although the causes of back pain are usually physical, it is important to know that emotional stress can play a role in how severe pain is and how long it lasts. Stress can affect the body in many ways, including causing back muscles to become tense and painful. Untreated depression and anxiety can make back pain feel much worse. Likewise, insomnia, or the lack of sleep, can also contribute to back pain. Make sure to share any possible physical and emotional causes of back pain when you visit a physician.

Heat Exhaustion & Dehydration

Heat exhaustion and dehydration often go hand in hand. Dehydration, which is a depletion or imbalance of fluids or electrolytes in the body, when coupled with extended exposure to sun or heat, can cause heat exhaustion. Although mild heat exhaustion and dehydration can be treated at home, the symptoms aren’t something to be taken lightly. Without proper care, severe heat exhaustion can progress to heatstroke, which can damage the brain and other vital organs, and even cause death. If your dehydration or heat exhaustion is severe, you may need a physician to administer IV fluids.

PREVENTING HEAT EXHAUSTION AND DEHYDRATION

If you know you will be exposed to high temperatures for an extended period of time, take these steps to prevent heat exhaustion and dehydration.

  • Drink plenty of water. The general daily water intake recommendation is eight 8-ounce glasses of water a day for women, and 12 8-ounce glasses a day for men. This guideline varies depending on the fluids a person is getting from food and other beverages, as well as their level of physical activity. As a rule, though, if you’re spending an extended period of time in high temperatures, you should consider eight glasses of water a day the minimum guideline.
  • Wear loose-fitting, comfortable clothes.
  • Cover up your skin from the sun as much as possible with clothing, hats, sun umbrellas, and always wear sunscreen. Sunburn or sunstroke can contribute to dehydration and heat exhaustion.
  • Limit physical activity. When the heat index is high, be aware that excessive physical activity (and sweating) increases your risk of dehydration and heat exhaustion.

SIGNS OF HEAT EXHAUSTION AND DEHYDRATION

Mild:

  • Dizziness
  • Fatigue
  • Headache
  • Muscle or abdominal cramping

Moderate:

  • Nausea, vomiting, or diarrhea
  • Pale skin
  • Profuse sweating or inability to sweat
  • Dry mouth and swollen tongue
  • Decreased urine output
  • Dark yellow or amber-colored urine

Severe:

  • Fever higher than 103°F
  • Fainting
  • Confusion
  • Lethargy
  • Seizures
  • Difficulty breathing
  • Chest or abdominal pains
  • Rapid heartbeat or palpitations

Insect and Animal Bites & Stings

Insect and spider bites are often no more than a nuisance, but occasionally they can cause dangerous symptoms and complications, especially if you have an allergic reaction or contract a disease from the bite. Throughout summer, more time spent outdoors means a greater risk of insect and spider bites, but you can stay safe from bug bites at barbecues, picnics, or sporting events by knowing how to prevent, diagnose, and treat bites.

If you experience any of the symptoms of allergic reaction or illness outlined below, you should seek immediate professional medical treatment at your nearest urgent care.

Preventing insect & spider bites

  • When going into the woods or other areas where you might come into contact with insects or spiders, always wear insect repellant and clothing that covers all areas of the body.
  • Wear gloves or closed-toed shoes if you are working in areas where insects and spiders are prominent, such as near piles of wood.
  • Avoid wearing perfumed lotions, aftershave, or scented hair products when spending time outdoors in the warm months.
  • Remove areas of standing water near your home or camping area.
  • If you encounter bugs or spiders, remain calm and avoid swatting or flailing. Instead, retreat slowly if insects appear threatening.

Symptoms of severe allergic reaction

Anaphylaxis is a severe, life-threatening allergic reaction. Signs of anaphylaxis typically occur within seconds to minutes of exposure and include sneezing, wheezing, hives, nausea, vomiting, diarrhea, sudden anxiety, dizziness, difficulty breathing, difficulty swallowing, chest tightness, and itching or swelling of the eyes, lips, or other areas of the face. Anaphylaxis is a medical emergency that warrants calling 9-1-1 immediately. If you or your child has had an allergic reaction to a sting or bite, you should be evaluated by an allergist. You may be advised to wear an allergy identification tag or to carry epinephrine, a medication used to treat allergic reactions in emergencies.

Symptoms of Lyme Disease

Lyme disease is transmitted through the bite of an infected tick, and can cause fever, headaches, fatigue, and a skin rash that looks like a circular red patch, or “bullseye.” Patients who are treated with antibiotics in the early stages of the infection usually recover rapidly and completely, but left untreated, infection can spread to the joints, heart, and nervous system.

Symptoms of West Nile Virus

West Nile virus, which is transmitted by infected mosquitoes, can produce flu-like symptoms, including fever, headache, stiff neck, body aches, and skin rash. While most infected individuals have mild symptoms and recover spontaneously, infection can be serious or even fatal. West Nile virus treatment consists of supportive care and, occasionally, intravenous anti-viral therapy.

Symptoms of Rocky Mountain Spotted Fever

Initial symptoms may include fever, nausea, vomiting, severe headache, severe neck pain, muscle pain, and lack of appetite. The characteristic red, spotted rash of Rocky Mountain Spotted Fever is usually not seen until the sixth day or later after symptoms begin, and as many as 10 percent to 15 percent of patients may never develop a rash at all. Rocky Mountain Spotted Fever is treated with antibiotics.

Signs of infection

It is normal for a bite or sting to result in redness of the affected area and minor swelling. However, if redness or swelling persists for more than 72 hours, or if a fever develops, it may signify an infection. Doctor-prescribed antibiotics are a common treatment for infection.

Should you suspect that you or a family member may be infected with any of the above diseases, or if you are experiencing any of the above reactions, please seek immediate medical attention.

Insect bite self-treatment

If you are stung or bit by a bee or insect, and do not notice any of the above symptoms of allergic reaction, illness, or infection, you can most likely treat the injury at home. Wash the bite or sting with soap and warm water, and apply a cool compress to reduce swelling. To ease pain, you can take NSAIDs, like aspirin or acetaminophen.

To reduce pain and swelling, apply an ice pack for up to 20 minutes once per hour for the first six hours. An oral antihistamine or cream applied directly to the sting, like Benadryl, may help relieve mild symptoms, like itching.

Because the symptoms of many insect-bite-transmitted diseases are similar to symptoms of the flu, but can have much more serious consequences, you should always visit a IMC Immediate Medical Care if you experience flu-like symptoms that won’t subside, or if you have persistent symptoms following self-treatment of a bug bite.

Burns

Minor burn symptoms and treatment

As children, “hot” is one of the first words we learn to signify danger. From too much sunshine, to hot pots and pans in the house, to slipping near a grill or fireplace, every day we encounter risks for burns that may require medical attention.

Burns are categorized into three levels based on severity. The varying degrees of burns have different symptoms and may require different treatments.

First-degree burns

First-degree burns can be caused by overexposure to the sun (sunburn), or brief contact with hot material.

A first-degree burn is a minor red burn affecting only the top layer of skin. The burned skin may be painful and slightly swollen, and it may make a person feel slightly feverish.

Minor first-degree burns can generally be treated at home by applying a cool compress (not ice) and taking aspirin or acetaminophen. If you’re not sure of the severity of the burn, it’s best to get a medical opinion.

Second-degree burns

Second-degree burns can be caused by contact with hot oil, grease, soup, or microwaved liquids. In rare cases, sun exposure can also cause second-degree burns. A second-degree burn means that the deep skin layers and nerve endings have been damaged. There are two types of second-degree burns:

  • Superficial partial-thickness burns injure the first and second layers of skin and are often caused by hot water or hot objects. The skin around the burn turns white (blanches) when pressed, and then turns back to red. The burn is moist and painful with blistering and swelling that usually lasts for at least 48-72 hours.
  • Deep partial-thickness burns injure deeper skin layers and are white with red areas. These are often caused by contact with hot oil, grease, soup, or microwaved liquids. This kind of burn is not as painful, but it can cause a pressure sensation. The skin looks spotted, remains white when pressed, may appear waxy in some areas, and is dry or slightly moist. Risk of infection is an important concern with these burns.

 

Immediately following this type of burn, you can submerge the burned area in cool (not cold) water, and take aspirin or acetaminophen to help alleviate pain. Loosely wrap the burn in sterile gauze if available, but do not apply ice or ointments to the burned skin unless directed by a medical professional.

Due to the risk of infection, it is recommended that you seek medical attention for any second-degree burns, especially those larger than three inches, or for any burns located on the hands, feet, face, groin, or buttocks, or over a major joint.

Third-degree burns

Common causes of third-degree burns are steam, hot oil, grease, chemicals, electrical currents, and hot liquids. A third-degree burn can cause severe pain and potentially result in permanent tissue damage.

Third-degree burns may look white, cherry red, or black, and they do not blanch (change color when you press on them). Although blisters may develop, third-degree burns are mostly dry, hard, and leathery-looking. If nerve endings are damaged, the burn may not hurt right away.

For severe burns, call 9-1-1 immediately. Make sure the burned area is no longer exposed to heat or burning materials, but do not attempt to remove any burned clothing. You can cover the affected area in sterile towels or gauze moistened with cool water, but do not submerge large areas of the body in cold water, as it may cause temperature shock or hypothermia.

If you’re not sure of the severity of a burn or are experiencing any of the symptoms of minor burns noted above, such as blistering or blanching, visit your nearest IMC Immediate Medical Care location for immediate medical care. For major burns, or if you or a family member is experiencing severe swelling, dizziness, mental confusion, or trouble breathing, call 9-1-1 immediately.

Cuts and Stitches

Signs a cut may need stitches

It’s not always easy to tell if a cut requires stitches. Ultimately, it’s up to your health care provider to determine if stitches are needed. You should seek medical care for any cut that:

  • Is deep, jagged, or gaping
  • Is on the face or another part of the body where scarring may be an issue
  • Bleeds profusely without stopping after 20 minutes of direct pressure
  • Feels numb
  • Is in a hand or limb that doesn’t function properly after being cut

If any of these criteria apply to your injury, see a doctor as soon as you can. In the meantime, apply direct pressure to help control bleeding. It might also help to raise the injured area above the level of your heart, if possible.

There are certain instances in which stitches may not be advised, such as puncture wounds, though you may still need to see a doctor, especially if you have not had a tetanus shot in more than five years.

The procedure

Once a health care provider has assessed your injury and determined that you need stitches, the first steps he or she will take in treating the wound are to clean and numb the area, though not necessarily in that order. Although cleaning a wound is not very painful in most cases, the doctor may first administer a local anesthetic, similar to what your dentist might use, to maximize your comfort. If your injury seems particularly contaminated, however, cleansing it – usually with running tap water and a mild soap — may be a higher priority.

Removal of stitches

Stitches typically need to remain in place for several days to a couple of weeks, depending on the severity of the cut and location. Your doctor will tell you when to come back to have them taken out. Removing stitches is a much faster process than putting them in. The doctor simply clips each thread near the knot and pulls them out. You may feel a slight tugging sensation, but the removal of stitches shouldn’t hurt at all. You won’t even need an anesthetic.

Although removing stitches is not a difficult process, you shouldn’t try to remove them yourself. It’s important for your doctor to check to see that the wound is healing properly and to make sure that it’s OK for the stitches to come out. The doctor may also have special instructions for you after the stitches are removed, which may help minimize scarring.

Sprains and Strains

How do sprains happen?

Sprains usually happen when a person falls, twists, or is hit in a way that forces the body out of its normal position.

The most common type of sprain is a sprained ankle. About 25,000 people sprain an ankle every day. Think of a runner who goes over a curb and catches her foot, twisting the ankle, or a baseball player who slides into a base and twists his knee.

Wrist and thumb sprains are also common, particularly in sports like skiing, where it’s not unusual to fall and land on an outstretched palm.

How do strains happen?

Athletes in contact sports, like football, hockey, and boxing, have the biggest chance of strains. Even in noncontact sports like tennis, golf, or rowing, doing the same motions over and over can lead to strains of the hand and forearm.

These injuries can happen when you work out at the gym, or they can happen at home or the workplace, especially if you do a lot of heavy lifting.

How can you tell the difference?

The signs of most sprains or strains are very similar: pain and inflammation, and sometimes bruising, at the injured area. Depending on how bad the sprain or strain is, the pain may be mild, moderate, or severe.

The worse the sprain or strain, the harder it is to use the affected area. Someone with a mild ankle sprain may just favor that ankle slightly. A more severe ankle sprain may cause much more pain and make it tough or impossible to walk.

If you have a sprain, your doctor may mention its “grade”:

  • Grade I is stretching of the ligament or a very mild tear, with little or no instability at the joint.
  • Grade II is a more serious but still incomplete tear, with some looseness in the joint.
  • Grade III is a completely torn or ruptured ligament. This is not a broken bone, but can feel like one since it’s often impossible to put weight on the joint or use the affected limb because the joint isn’t stable.

Broken Bones

What causes bones to break?

From the crunch of a sports injury to an accidental fall, people break bones in all kinds of ways – usually from some sort of impact. Bones are strong and even have some give to them, but they have their limits, too. They can even bleed after a serious break. Diseases like cancer and osteoporosis can also lead to breaks because they make your bones weaker and more fragile.

What kind of break?

Doctors talk about broken bones, also called fractures, with a few basic terms:

  • Open or closed? Closed, or simple, fractures don’t break through the skin. Open, or compound, ones do.
  • Partial or complete? Partial breaks don’t go all the way through the bone. Complete breaks mean the bone is in two or more pieces.
  • Displaced or non-displaced? If the broken pieces still line up, it’s a non-displaced break. If they don’t, it’s displaced.

What it feels like: pain

Sometimes, kids get small fractures and don’t even know it. Other times, your body may be in shock so you don’t feel anything at all – at first. But usually a broken bone means a deep, intense ache. And depending on the break, you may feel sharp pain, too.

What it feels like: other symptoms

Aside from pain, your body sets off all kinds of alarms to tell you something’s really wrong. You might feel chilly, dizzy, or woozy. You might even pass out.  Around the break itself, you might notice:

  • Bruising
  • Stiffness
  • Swelling
  • Warmth
  • Weakness

You may also have trouble using that body part or see that the bone doesn’t look right – like it’s bent at an odd angle.