What is serious back pain?

Very few cases of back pain indicate a serious underlying condition that requires ongoing medical management. So what’s the point of seeking medical care for pain?

For one, timely access to professional healthcare for back pain is important for avoiding the consequences of a serious disease or disorder. Regarding back pain, urgent conditions may involve recent trauma, such as a fall, cancer, and issues affecting the nerves or broader nervous system. Healthcare professionals are trained to quickly identify serious health conditions during routine visits to the clinic or ER. Generally, their diagnostic process involves a sequence of interviewing, maneuvering, testing, and general observation. Also, a thorough analysis of any personal health history that may be influencing the current experience of pain.

The initial medical evaluation for back pain is organized around the detection of “red flag” signs and symptoms. Providers rely heavily on their skills during the history taking or interview components of the exam to identify patients with red flags. For back pain, these include:

  1. A recent accident, injury, trauma, or medical procedure.

Back pain associated with any of these circumstances is highly unpredictable and may lead to serious harm. Immediate medical attention is needed to address the risk of forgoing care and experimenting with inadvisable remedies.

2. Trouble controlling urges to use the bathroom. Feelings of pins and needles (especially around the groin area). Sudden feelings of impairment or disability.

These are urgent findings that are likely to lead someone to the ER or an urgent medical consult. Back pain associated with any of the above signs or symptoms is suggestive of cauda equina syndrome (CES). CES is a rare, but serious condition affecting the nerves near the bottom of the spine. Immediate medical attention is required to avoid future disability.

3. Fever, chills, night sweats, or unexpected weight loss.

Back pain that occurs with any of these signs or symptoms suggests that some other disease or disorder may be causing pain. Other factors include age and previous health records. Back pain in patients who are younger than 18 or older than 50 years of age is evaluated with greater scrutiny. This also applies to back pain in patients who have a history of cancer or a challenged immune system.

Generally, CES is the only condition that warrants immediate emergency medical attention. However, the presence of red flags serves as a clue for healthcare professionals to work hard and fast to rule out specific diagnoses associated with more serious or debilitating health conditions. If you experience “red-flag back pain” at any time, this should encourage you to seek medical attention as soon as possible. Also, you should recognize that experiencing back pain without red flag signs or symptoms is not a reason to forgo care completely.

After ruling out concerns of a serious medical crisis by screening for red flags, providers will usually perform an additional sequence of questions and maneuvers to better understand their patient’s pain. Frequently, patients' experiences with pain can be matched to specific guidelines for relief. For example, some types of pain are known to respond well to general movement. Over the short term, patients will get better by simply moving around more frequently. Other types of pain are known to respond to directed movements and more advanced therapies.

Living with back pain can be overwhelming - Finding relief may seem confusing and expensive.

Contact us to request an appointment - Get to the root cause of your pain.

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