How Do You Know When Back Pain Is Serious?

Find out how to spot red flags that can indicate a serious condition.

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In many cases, back pain can be as commonplace as a mild headache, a sneeze here and there, or eye strain. In fact, non-specific low back pain is a frequent ailment. One study reports that the lifetime prevalence of chronic low back pain is as high as 84%, making one’s chances of experiencing discomfort at one time or another pretty high.

Severe back pain - featuredHere's how to tell if your back pain may be something serious

Then there are those other times, when the back pain just doesn’t feel right and your gut is saying that something more is going on. Many people have been known to go to the emergency room when experiencing low back pain—in 2012, a study found that low back pain accounted for 3.15% of all emergency visits in the United States. When you consider how many conditions can land someone in the ER, that number is fairly substantial.

Let’s say that you’re experiencing a significant amount of back pain, wondering, “How do I know if my back pain is serious?” This guide will help you decide if it warrants a trip to your doctor or the emergency room.

Signs of Something Serious

So, can back or neck pain be a sign of something serious? An expert helps us navigate the waters.

“While back pain is very common and usually benign and self-limiting, there are some signs and symptoms which could indicate a more serious medical condition requiring further evaluation and treatment,” says Mark Drymalski, MD, Medical Director of the University of Missouri Health Care’s Comprehensive Spine Center.

According to Dr. Drymalski these red flags can include:

  • Persistent fevers
  • Unplanned weight loss
  • Blood in the stool or urine
  • Progressive numbness or weakness in the legs
  • Inability to urinate or have a bowel movement
  • Loss of bowel/bladder control
  • Pain at night
  • Sexual dysfunction
  • Balance problems
  • Pain not alleviated or worsened by different positions
  • Recent IV drug use
  • Progressive worsening of pain despite relative rest
  • Recent trauma

Some symptoms can come on suddenly while others can ramp up gradually. There are several conditions that can bring on these so-called red flags.

Possible Conditions Causing Severe Back Pain

Dr. Drymalski also details several conditions that can cause intense back pain, many of which center on the bones or discs. But you also might be wondering, “How do I know if my back pain is kidney-related? Problems with what other organs can cause lower back pain?”

He shares a wide-ranging list of potential conditions that can bring about extreme back pain:

Spotting the Signals

Although that list of possible conditions may seem daunting, the important thing to do is to focus on your symptoms and how you’re feeling. Also, be sure to consider any symptoms that you’re experiencing beyond back pain.

Severe back painPay attention to severe back pain and other symptoms that appear with it.

“Pay attention to the other symptoms in addition to your back pain, especially your bowel/bladder function and leg function,” Dr. Drymalski says.

He adds that if you demonstrate any of the above red flag symptoms, if your pain persists and does not appear to be related to movement, or if you have a history of cancer, recent IV drug use, or a vascular disease, you may be at increased risk for serious back conditions.

Diagnosis and Treatment

Luckily, you won’t have to navigate these signs and symptoms alone. This is where a doctor’s expertise comes in.

Dr. Drymalski explains, “If red-flag symptoms are present, urgent or emergent imaging, bloodwork, and evaluation may be required, which is best accessed through a local emergency department.”

When it comes to seeking a doctor’s diagnosis, the very best thing is to go in as soon as you think something could be wrong, since early and thorough treatment can help you avoid more serious symptoms and conditions.

“Early identification and treatment of many of the severe spine conditions, such as meningitis, discitis, and cauda equina syndrome from a disc herniation or mass, is essential to prevent death or a protracted hospitalization in some cases or permanent neurologic impairment, such as permanent leg weakness or bowel/bladder dysfunction, in others,” Dr. Drymalski says.

Get Help for Your Back Pain

While this all may sound dire, you can take comfort in knowing that upwards of 90% of low back pain presentations in the ER are benign, according to findings. The important thing is to stay as calm as you can as you assess your pain and symptoms and rely on medical experts to assist you and get down to the bottom of why you’re feeling the way you are.

Dr. Drymalski emphasizes, “Remember that back pain is very common and the vast majority of the time it will be self-limiting and benign. If you are concerned or have red-flag symptoms, emergent evaluation may be necessary. It is important to always tell your doctor all of your symptoms, even if you don’t know if they are related to your back pain, so your doctor can develop the most appropriate workup and treatment plan for you.”

Updated on: 06/26/20
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When Is Back or Neck Pain an Emergency?
Santhosh A. Thomas, DO, MBA
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When Is Back or Neck Pain an Emergency?

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