Raising the Red Flag: When to Get Help — Now

Back pain is one of the most common types of pain people experience.  Most episodes of back pain are due to strains or sprains and often get better with common sense approaches and self-care.  If the condition is not serious, it will improve in a few days and gradually go away in a few weeks.  However, sometimes back pain can indicate a serious medical condition that requires urgent medical attention.

You should see a healthcare provider or go to an emergency room if you experience symptoms such as:

  • Increased back pain when lying down or sleeping
  • Pain that shoots down one or both legs
  • Numbness, tingling or weakness in one or both legs
  • Back pain associated with new bowel or bladder problems (such as loss of control)
  • Back pain that is intense following a sudden fall or injury
  • Severe back pain with fever
  • Constant, severe pain that doesn’t improve in a few weeks of responsible self-care

When the above symptoms occur, it is very important to find out what might be causing the pain.  An example of a reason to seek immediate attention is intense pain after a fall, which may indicate there is a fracture of one of the bones in your spine, the vertebra.

If you have never had a back problem, having a sudden attack of back pain for no apparent reason may be more serious than if you have a chronic back problem and are used to its natural course.  For example, pain that spreads to the legs, or sciatica, is a common symptom of a chronic lower back problem.  An important factor to consider in deciding whether to seek medical care is how much the pain is affecting your ability to perform everyday activities.  If you shovel snow one day, and your back aches for a few days afterwards, that would be considered normal.  If you are unable to get out of the bed the next morning, you should contact your doctor and ask for an appointment that day or, if that isn’t possible, go to an emergency room.

Sometimes back pain is accompanied by other symptoms that may seem unrelated but still indicates the need for immediate medical attention.  For example, if you have back pain and blood in the urine, it can indicate a kidney condition, such as kidney stones, which can cause considerable back pain.  While aches and pains often accompany the flu, severe back pain with a fever may indicate a serious infection.

There are other symptoms that mean you should get prompt, if not urgent, medical attention.  The spine can deteriorate due to age, arthritis, osteoporosis or osteopenia (weak bones due to mineral loss) and cause pain that needs medical care.  People who have back pain while taking steroids or during or after cancer treatment should see a doctor.

If what appears to be a back sprain or strain doesn’t improve with two weeks of self care and interferes with normal activities, see your healthcare provider.  Lying in bed and taking pain relievers for a prolonged period of time is no longer the recommended home treatment for back pain; it is important to keep moving as much as your pain permits.  Medical care may be needed when ordinary movements cause pain.

In general, it is better to get treatment soon after symptoms appear.  A delay may make the condition worse.  A physician will be able to diagnose your condition and start you on a course of the appropriate treatment that can start trying to help you get moving again without pain.

References

Sinel, M.S., Deardorff, W.W. (1999). Chapter 5, Knowing When to See Your Doctor, in Back Pain Remedies for Dummies. New York: Wiley Publishing.

The National Institute of Arthritis and Musculoskeletal and Skin Diseases (2005). Handout on health: back pain. Retrieved June 19, 2008, from http://www.niams.nih.gov

MedlinePlus Medical Encyclopedia (2007). Back pain: when to contact a medical professional. Retrieved June 19, 2008 from http://www.medlineplus.gov