Everyone has back pain from time to time. In greater than 85% of cases, back pain is nonspecific and not serious. Most patients with nonspecific back pain improve within a few weeks without specific treatment.
Some cases of back pain are serious, however. How can you or your physician know if back pain is serious or not? When physicians attempt to determine whether back pain is serious or not, they look for “red flags.” Red flags are signs, symptoms, or historical details that may indicate a serious problem is actually occurring.
While it is always prudent to see a physician for a new back pain doctor nj, especially pain that is caused by a specific injury, you may want to check to see if you have any back pain red flags.
Red flag symptoms
New back pain can be considered a medical emergency in when it occurs with other findings or circumstances. Perhaps the most worrisome is a condition calledcauda equinasyndrome. Cauda equinasyndrome occurs due to damage of bundle of nerves at the base of the spine, called the cauda equina. Cauda equinasyndrome may cause pain, numbness, or tingling in the back that extends down one or both legs. The most fearsome symptom of the syndrome is a sudden loss of bowel or bladder control (or the inability to urinate). Patients who have back pain with these symptoms should seek medical advice immediately.
Another serious back pain red flag is a focal neurologic deficit with progressive or disabling symptoms. In simpler terms, this is any back pain causing weakness or numbness in a specific region of the body (e.g., one leg) that gets worse with time or interferes with physical functioning. These symptoms could indicate a serious cause lower back pain.
Age-related red flags
Most people start to have some sort of back pain before the age of 70. It is unlikely for someone to experience sudden back pain for the first time after the age of 70, thus, any new or different back pain that starts after the age of 70 is considered a red flag. It should be evaluated by a physician as soon as possible. For all women, or men with osteoporosis, any new back pain that occurs after the age of 50 should also be evaluated by a doctor.Most cases of back pain will resolve on their own within a few weeks; however, back pain that lasts longer than six weeks may mean something more serious is happening.
Red flags based on past medical history
Patients with certain features in their past medical history are at greater risk for serious causes of back pain than people without these features. Notably, anyone with a history of cancer, regardless of type, should have any new back pain evaluated by a physician. The same is true for anyone with a history ofabdominal aortic aneurysm or diabetes. Diagnosed osteoporosis is a risk factor for spinal fractures, specifically compression fractures of the spine. Anyone with osteoporosis should take new onset back pain seriously.
People with suppressed immune systems either from disease or from medical treatment, should seek medical attention for their new onset back pain. Patients may have suppressed immune systems from uncontrolled HIV/AIDS, inherited immunodeficiency disorders, or malnutrition. Several forms of medical therapy can cause immunosuppression from antirejection drugs given to organ transplant recipients to people who take chronic corticosteroids for autoimmune disorders.
Red flags based on potential causes
Two serious causes of low back pain are fracture and infection, cancer. Therefore, signs and symptoms that would suggest either of these causesare red flags. Fracture is more likely in people with osteoporosis or who have sustained severe trauma to the spine. Likewise, people who sustain repeated, relatively minor injuries to the spine (e.g., gymnasts, performers who fall from heights, professional athletes, etc.) may have fracture-related back pain.
Infections in and around the spine are more likely in patients who are immunosuppressed/immunocompromised, are malnourished, or are intravenous drug users. IV drug users are at great risk of introducing infectious materials directly into veins. Immunosuppressed individuals are unable to fight off even minor infections. Patients in either these categories should take back pain quite seriously and seek medical evaluation.
Err on the side of caution
If you are worried about back pain, regardless of red flags, consult a physician. If you have new onset back pain and any of the red flags mentioned above, you should seek medical attention promptly. Loss of bowel or bladder function with back pain is considered a medical emergency and should be immediately evaluated by medical professional.