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When to Worry About Back Pain.

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The bark of most back pain is worse than the bite, even when the pain levels are quite bad or even debilitating its usually nothing serious. Although for small percent of back pain suffers will have an underlying pathology or medical issue which is less than 3%. Without trying to oversimplify things most back pain felt stem from the soft tissues namely the muscles, although these are very often overlooked as a major contributor.

Things like MRI’s & x-rays a notoriously bad at diagnosing back pain when it comes bulging discs, arthritis, “alignment” etc… which were all previously associated with back pain in the past and often misleading. However, when I am treating someone for the first time or even over an extended period of time I always have in the back of mind and on the look out for anything that may indicate a more serious cause of their pain, such as autoimmune diseases particularly rheumatoid arthritis or other autoimmune arthritis, cancer, infections, fractures and several other culprits which may be a more serious cause of back pain.

This article is just to give you a very brief background in how to discern the difference between common musculoskeletal back pain and a more serious cause of your back pain. If you have any concerns its always best to see you GP or health practitioner such as a chiropractor or physiotherapist for a detailed assessment. It’s worth mentioning even more serious causes of back pain may not be painful and may fly under the radar at least at the beginning but usually becomes more apparent as time goes on. The level or intensity of pain overall is not a good indicator, but the type of pain and when it is or isn’t felt is often noteworthy. On the flip side you can have extreme back pain and it may be nothing more than a muscle spasm, I usually explain it to my patients it’s similar to having a calf cramp which is very painful but the cramp involves the muscles around your spine and can’t just be stretched out like a normal cramp.

Two symptoms or situations that require urgent medical attention is numbness around groin and buttocks with or without loss of bowel/bladder control. Or when you have experienced force from a fall or accident sufficient to cause a fracture, this may be falling of a ladder (even a low one), off a bike etc… even if pain levels are that high.

Three signs that need to be investigated further but not considered medical emergencies like the two example above.

  1. You have felt back pain for more than 6 weeks.
  2. If the pain has stayed the same or actually gotten worse.

(Both if these are even more important if you have been getting treatment.)

  • There is at least one coinciding “red flag from the list below”.

List of “ red flags” which are signs and symptoms of a more serious cause of back pain.

History of corticoid steroid use (especially important for fracture(s)

General signs of illness such as fever, chills

Unexplained weight loss

Family history of autoimmune disease, gradual but progressive increase of pain particularly before the age of 40 and unresponsive to treatment, significant low back stiffness in the morning, rashes etc..

“sciatic” like symptoms pain and needles and numbness in both legs, less of a concern if located in one leg.

Current or previous history of cancer.

So if you are experiencing back pain and you fit the description for potential serious cause of back pain it may be a good idea to book in to see your GP.

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