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When to seek medical advice
Certain warning signs should alert a patient to see a doctor immediately for low back pain. Any very severe back pain warrants attention, particularly if any of the following conditions are present:
• Being over 50
• Recent injury
• Very sharp or severe pain
• Pain awakens the person at night
• Pain accompanied by fever (possible infection)
• Pain increased by lying down
• Pain unrelated to movement
• Pain lasts for a month, and is accompanied by unexplained fever or weight loss
• History or chronic use of corticosteroids
• Steroids or intravenous drug use
• History of urinary tract infection
• Burning with urination or blood in your urine.
• In children, any severe neck or back pain or pain that persists for more than 3 days
• Redness or swelling on the back or spine.
• Pain traveling down your legs below the knee.
• Weakness or numbness in your buttocks, thigh, leg, or pelvis.
• You have been losing weight unintentionally
• You have never had or been evaluated for back pain before.
• You have had back pain before but this episode is distinctly different.
• This episode of back pain has lasted longer than four weeks.
If some of these symptoms are present, your doctor will carefully check for any sign of infection (like meningitis, abscess, or urinary tract infection), ruptured disk, spinal stenosis, hernia,
cancer, kidney stone, twisted testicle, or other serious problem.
Call 911 if you have lost bowel or bladder control.
Cauda equina syndrome is the impingement of the cauda equina (the four strands of nerves leading through the lowest part of the spine). It is an emergency condition that can cause severe complications
of the bowel or bladder. Cauda equina syndrome is usually caused by massive extrusion of the disk material. It can cause permanent incontinence if not promptly treated with surgery. Symptoms of
the cauda equina syndrome include:
• Dull back pain
• Weakness or numbness in the buttocks, in the area between the legs, or in the inner thigh, backs of legs, or feet. May cause difficulty in standing or stumbling.
• An inability to control urination and defecation
Pain accompanied by fever (can indicate an infection)
Reviewed By: Harvey Simon, MD, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital.
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