Red Flags to See your Doctor About Back Pain

What can you do to tell if your back pain is too severe for you? Experts are unanimous in their recommendation that you seek professional assistance if back pain occurs in combination with the following symptoms.

Low back pain can be characterized by several warning signs that should alert doctors.

This is done to alert you of possible spine problems such as tumors and fractures. You should see your doctor immediately if you experience any of the red flags, along with pain in the back.

While your back may be tender from the flu, an unresponsive fever and back pain can also indicate a more serious condition. Richard Guyer MD is an orthopaedic physician and founder of Texas Back Institute. Guyer also serves as Associate Clinical Professor of Orthopaedics for the University of Texas Southwestern Medical School.

You can expect the following: An infection should be ruled out by your primary doctor. Antibiotics might be recommended if it's an infection. A few days rest may be necessary if your doctor has ruled out the possibility of an infection. Sometimes, back pain is secondary or primary to an infection. Doctors recommend gradually resuming daily activities once you feel better. You can make your back problems worse by resting for longer than one day.


Your doctor may want to examine your back pain if there has been a severe trauma (such as an accident at work or falling from height) or minor trauma. A fracture can even be caused by falling down just a few times when you are older.

You can expect your doctor to take an X-ray. If there are no fractures, your doctor may prescribe medication to manage the pain and then you can get physical therapy for your rehabilitation.

Tingling, Numbness

While you may think you can get rid of numbness, tingling or pins and needles with medication over-the counter, it is more likely that nerve irritation or damage has occurred. This is the case for most patients, according to Todd Sinett of New York City, who is also author of The Truth About Back Pain. Nerve pressure can be caused by a number of conditions, such as herniated discs or spinal stenosis. Sinett states that nerve irritation and damage to the nerves can result in permanent disabilities if it is not treated.

Expectations: First, see your primary doctor to get an evaluation. The diagnosis will determine the treatment. Further testing may be required to view the spine and test nerve conduction.

The loss of the Bladder or Bowel Function

Cauda Equina Syndrome is a serious, rare condition in which nerve roots at the bottom of the spine cord are compressed and paralyzed. Back pain can occur in conjunction with loss of bladder or bowel control. A herniated disk or fracture, tumor, spine stenosis or injury to the spine can cause this. These symptoms can occur over time, and may include weakness and numbness in the legs. Cauda Equina syndrome, a medical emergency, requires immediate care.

Guyer explains what to expect. "Your doctor will perform surgery to decompress nerves to alleviate the nerve damage."

A medical history of cancer or an immune suppression, osteoporosis, chronic steroid abuse, or a family history.

Your doctor may want to rule out the possibility of back pain due to cancer spreading if you have a history of it. Your doctor could suspect that your back pain is caused by immune suppression. Your doctor could suspect that your back pain is caused by osteoporosis, chronic steroids use or a history of fractures.

You can expect the following: To check for a possible tumor, infection, or fracture, your primary care physician may recommend blood tests or an MRI. For an infection, you may need to take antibiotics. Fractures may be managed with physical therapy or medication. Radiation therapy and medication may be used to manage pain from cancerous tumors that have spread to the spine.

Foot drop

Sinett says that foot drop can occur when your feet drag on the ground, or if you feel like you need to lift your foot up to counter the dragging. This condition is often accompanied with back pain. Foot drop can be a sign of something more serious, such as a nerve problem that causes the muscles to raise your foot or a muscle problem.

You should expect the following: First, your doctor needs to determine what is causing the foot drop. Your doctor may recommend physical therapy as well as steroid injections, in the event of a suspected herniated disc.

Night Pain

It's all fine and dandy during the day. But once your head touches the pillow, your back hurts, which makes it nearly impossible to fall asleep. Sound like you? Sinett states that pain in the morning can indicate disc degeneration, a sprain or something worse like cancer or tumors. The bottom line is that nighttime back pain should not be ignored. Get to the doctor as soon as you can.

Expectations: A primary care physician may request tests such as a blood test or an MRI in order to rule out infection.

Unexplained weight loss

Unexpected and unexplained weight loss can be a sign that your doctor is looking for possible back problems.

You can expect your doctor to order blood work and an MRI in order to rule out infection. You may receive pain medication if these tests come back negative. For back pain, you may be eligible for pain medication or physical therapy.

Chronic Pain for 6+ Weeks

95% of back pain patients improve within 6 weeks. Your doctor might want to examine more serious causes, if the pain persists after this time.

What you can expect: Following an examination of your symptoms, and possibly a physical exam to determine the diagnosis, your primary doctor might order imaging tests and bloodwork.

The Advanced Age

Over 70 years old can lead to infection, cancer, or abdominal pain.

You can expect your doctor to perform diagnostic tests, including imaging and blood work to rule out other causes.

IV Drugs

Patients who are exposed to IV drugs for a long time are at higher risk.

You can expect your doctor to order bloodwork to confirm infection. In the event of an infection, your doctor will likely order blood work.