Surprisingly, severe back pain isn’t usually a true medical emergency. One of the most common reasons people go to the emergency room is severe back pain from a simple muscle strain or joint sprain. While these conditions can be extremely painful, they usually don’t indicate serious soft tissue or other structural joint or ligament damage to the back.
However, there are some back-related problems that could very well indicate a medical emergency. You should seek medical help immediately if you experience any of the following symptoms.
1. Progressive weakness in the legs or loss of bladder or bowel control.
The sudden onset of bladder or bowel incontinence or progressive weakness in the lower extremities can be an indication of a relatively rare but serious condition called cauda equina syndrome. Anyone experiencing these symptoms should seek immediate medical attention. Typical symptoms of cauda equina include:
• Altered sensation, or severe or progressive weakness or numbness in the legs or feet;
• Loss of sensation or altered sensation in the “saddle” area (the area or your body that would sit on a saddle: inner thighs/between the legs, buttocks, back of legs, sacral region);
• Loss of control of bladder or bowels (including retention or incontinence); and
• Pain, numbness or weakness in one or both legs that may cause difficulty walking.
Cauda equina syndrome is caused by the compression of nerves in the low back, which can happen from a trauma to the spine, any spinal condition that may compress the nerves (such as a disc herniation or spinal stenosis) or an infection. If left untreated, this syndrome can ultimately result in paralysis, as well as continued loss of sensation in areas below the lower spine.
2. Unexplained loss of appetite, weight loss, pain or neurological problems.
Weight loss from increased exercise or changes in diet can be healthy and can help reduce back pain. However, sudden weight loss or lack of appetite for no known reason can be indicative of a serious medical condition, such as cancer. Several symptoms of a tumor in the spine include:
• Pain in the neck or back, followed by weakness or numbness of the arms or legs;
• Change in normal bowel or bladder activity;
• Back pain that does not diminish with rest, and pain that may be worse at night than during the day; and
• Nausea, vomiting, or fever, chills or shakes in conjunction with back pain.
3. Fever, some type of increased pain, and other symptoms of infection.
Fever typically indicates some form of infection. An infection of the spine can either occur quickly (within one or two weeks following fusion surgery) or develop over time (as in elderly persons or those with compromised immune systems).
Spinal infections are rare, but can be quite dangerous if the infection moves into the spinal canal and causes an epidural abscess (a pus-filled cavity in the epidural space). Pressure from an abscess pressing on the nerve structures in the neck or back can result in paraplegia or quadriplegia.
4. Severe, unrelenting abdominal and lower back pain.
The pain of an abdominal disorder can often extend to the back and be felt as acute, continuous low back pain. Acute lower back pain can be a symptom of an enlargement of the aorta (large artery) in the abdomen, called an abdominal aortic aneurysm.
If the blood vessel ruptures or starts leaking blood, this could become a serious medical emergency. The primary symptoms of an abdominal aortic aneurysm are severe continuous abdominal and lower back pain.
This is a life-threatening condition. Anyone with these symptoms needs to seek immediate medical attention.
The above conditions are quite rare compared to the common causes of back pain, and most conditions that cause back pain do not require immediate medical care.
Once your chiropractor or medical doctor rules out the above causes of low back pain, conservative treatment should commence.
The most frequently used and successful treatment for mechanical low back pain is chiropractic treatment. Once the problem is corrected and the symptoms alleviated, then you should discuss with your chiropractor what lifestyle changes would help prevent it from occurring again.
