How Do I Know If My Back Pain Is Serious?

Back pain can be serious when it is accompanied by symptoms such as sharp pain versus a dull ache, pain that radiates or shoots to the legs or buttocks, sudden weakness in the legs, incontinence, numbness or pins and needles in the groin or glutes; and leg weakness, incontinence, and numbness together.

The back is made up of bones, muscles, joints, and ligaments and it is possible to have back pain in any part of the back. 

Back pain can occur from even simple movements such as bending to pick something up from the floor, but there are many different causes of back pain, such as:

• Accidents
• Fractures
• Sports injuries 
• Scoliosis and kyphosis
• Herniated discs
• Bone infections
• Poor posture
• Obesity
• Osteoporosis
• Arthritis
• Ankylosing spondylitis
• Sacroiliitis
• Degenerative disc disease
• Psychological stress
• Diseases of the internal organs, such as kidney stones or kidney infections, or blood clots
• Multiple sclerosis
• Transverse myelitis
• Thoracic or abdominal aortic aneurysms

Back pain is often classified based on duration of symptoms: 

• Acute back pain usually lasts less than 4 weeks
• Subacute back pain lasts 4 to 12 weeks
• Chronic back pain lasts more than 12 weeks

Most of the time, back pain is not caused by a serious condition, such as inflammatory arthritis, infection, fracture, or cancer, but it still remains a leading cause of disability worldwide. 

See a doctor if you have symptoms that back pain may be a sign of a serious condition, such as: 

• Sharp pain versus a dull ache
  • May be a sign of a torn muscle or ligament or a problem with an internal organ 
• Pain that radiates or shoots to the legs or buttocks
  • May be a sign of nerve compression or nerve damage
• Sudden weakness in the legs
  • May be a sign of compressed nerves in the spine due to conditions such as sciatica or spinal stenosis
  • May also be a sign of a stroke
• Incontinence (inability to control the bladder or bowels) or inability to urinate
  • May be a sign of serious nerve compression or a spine infection, such as discitis or meningitis
• Numbness or pins and needles in the groin or glutes
  • Called “saddle anesthesia,” this is a sign of a serious nerve or spine condition
• Leg weakness, incontinence, and numbness together
  • Could be a sign of cauda equina syndrome, a medical emergency characterized by spinal cord nerve damage
  • Immediate surgery is usually required to decompress the nerves and reduce permanent damage

Also see a doctor if back pain is accompanied by the following symptoms, which may also be signs of a serious condition: 

• Persistent fever
• Weight loss
• Blood in the stool or urine
• Recent trauma
• Progressive worsening of pain despite relative rest
• Progressive numbness or weakness in the legs
• Inability to urinate or have a bowel movement
• Pain at night
• Sexual dysfunction
• Balance problems
• Pain that does not go away or worsens in different positions
• Recent IV drug use