9 Signs Your Back Pain Is Actually an Emergency, Research Shows

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Medical experts reveal the signs and symptoms that indicate your back pain may actually be an emergency.

Back pain is more common than you think

Does your back hurt? You’re not alone. Over half of American adults report having back pain every year and it’s estimated that over 80 percent of people will experience a problem with back pain during their lives, according to the American Chiropractic Association. And we’re not just talking aches and pains, back issues can be serious. Low back pain is the single leading cause of disability worldwide and is the second most common reason for visits to the doctor’s office, outnumbered only by upper-respiratory infections, according to the most current Global Burden of Disease report published in The Lancet.

The two types of back pain

But while back pain is very real and can be quite debilitating, the good news is that most cases of back pain are mechanical or non-organic—meaning they are not caused by serious conditions but rather things like a sports injury or bad posture. However, there are times when back pain can indicate an underlying issue that needs immediate attention, says Neel Anand, MD, professor of orthopaedic surgery and director of spine trauma at Cedars-Sinai Spine Center in Los Angeles. “It’s important to know the difference between ‘I overdid it at the gym’ pain and ‘bad’ pain,” he says. “Back pain that doesn’t go away or start to feel better after a few days, intensifies, or is excruciating is always a bad sign and needs to be taken seriously. Call your doctor right away.”

You recently injured your back

If you are in a car accident or other serious event, it’s common practice to get your back and neck checked out but many people don’t realize they can sustain serious injuries from less drastic events. “If your pain is far more than you’d expect, if it feels worse over time instead of better, or is incredibly painful, get it checked out, even if you think it’s minor,” Dr. Anand says. Whenever you directly injure your back it’s possible to have a spinal injury. Another possibility is a “pathological fracture” where a tumor has weakened your spine and then it fractures during a relatively small event, he explains. “Sometimes this type of back pain is the way people learn they have cancer,” he adds.

You’re losing weight

Rapid, unexplained weight loss is never a good sign. And when it’s accompanied by back pain, it could be a sign of a tumor in the spine, says Neelima Denduluri, MD, a medical oncologist in Virginia, a clinical assistant professor at Georgetown University Medical Center, and the associate chair of The US Oncology Network Breast Committee. Cancerous tumors that press on the spine can also affect your stomach, making you lose your appetite, she says. Some tumors start in the spine, but more often they spread there from another location, such as the lung, breast, kidney, and prostate—which makes getting treatment fast even more crucial.

You can’t control your bladder

Back pain combined with bladder or bowel incontinence, or a feeling of increasing weakness or numbness in the legs, pelvis, and hips, could be serious, says S. Adam Ramin, MD, a Los Angeles-based urologist, medical director of Urology Cancer Specialists, and assistant professor of surgery at City of Hope National Medical Center. These symptoms can indicate a variety of illnesses and conditions that need immediate attention including multiple sclerosis, some types of cancer, nerve damage, or an infection, he says. Another symptom of this type of nerve injury is if you have no feeling when you wipe with toilet paper.

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