When is back pain an emergency?

Low back pain can certainly be uncomfortable – but it’s not usually an emergency. Still, because back pain can be an emergency, it’s important to know what symptoms to look for and when to seek prompt care.

See the specialists at Advocate Health Care for low back pain diagnosis and treatment. We help you find pain relief so you can get back to the activities you love.

What is a red flag for back pain?

If back pain is a medical emergency, you’ll likely feel intense, sudden symptoms. You usually also experience one or more red-flag symptoms along with low back pain, such as:

• Difficulty standing or walking
• Loss of bowel or bladder control
• Loss of consciousness
• Pain that extends from the lower back around to your abdomen
• Sudden numbness in your pelvic region or in one or both legs

If you experience any of these symptoms, seek emergency care or call 911 immediately. These symptoms can indicate a problem with your blood vessels, spine or nerves that could cause lasting damage if you don’t receive treatment right away.

What emergency conditions cause lower back pain?

Some conditions that cause lower back pain can damage your nerves, back or leg function without timely treatment, including:

• Abdominal aortic aneurysm (AAA): An AAA is a weak spot in the wall of your abdominal aorta, the main artery that runs from your heart down through your abdomen. AAAs may cause continuous, stabbing pain in your low back and abdomen. You may also experience a racing heartbeat, shallow breathing or cold sweats.
• Cauda equina syndrome: The nerve roots in your lower spine (cauda equina) may compress, restricting sensation and movement. Along with low back pain, cauda equina syndrome may cause loss of bladder control and numbness in your inner thighs, genitals, groin or buttocks.
• Vertebral osteomyelitis: An infection develops in your vertebrae. Vertebral osteomyelitis is rare and usually develops because an infection in another part of your body has spread to your spine. The infection may also cause a fever, swelling, redness around your lower back or unexplained weight loss.

Who is more likely to experience a back pain emergency?

Lower back pain emergencies can happen to anyone. But some factors increase your risk, including:

• Age: People older than 50 and younger than 18 are at the highest risk.
• Health history: Immunocompromised people have an increased risk.
• Underlying conditions: Diagnoses like osteoarthritis or osteoporosis can raise your risk.

How can you tell if back pain is muscular or something else?

Low back pain is often the result of a strained muscle or pulled ligament. If your back pain is muscular, you may notice symptoms such as a dull ache, bursts of pain with muscle contractions (muscle spasms) or pain that worsens when you move.

But lower back pain may also be neurological, meaning it develops because of a problem with your nerves. Neurological conditions may cause lower back pain along with:

• Bowel or bladder problems
• Chills or fever
• Pain that radiates to your legs
• Tingling, numbness or weakness in your legs
• Unexplained weight loss

How long can lower back pain last?

Experts separate low back pain into two types, depending on how long it lasts:

• Acute low back pain lasts several hours or days.
• Chronic low back pain lasts three months or longer.

In general, you should seek immediate medical care if you experience lower back pain that:

• Comes on after a traumatic injury, such as a car accident
• Develops suddenly and severely
• Is accompanied by other red-flag symptoms
• Lasts for 12 weeks or longer