When I search low back pain on google the first question that comes up under what “People also ask” is What are the red flags for low back pain. Essentially, how do I know if my low back pain is something serious or not. Great question! Who doesn’t want to know if the pain they are feeling is something that they can work through, or is something that the need to go to the emergency room immediately. There are 5 main serious causes of medical conditions that should be considered when looking at low back pain: tumors, cauda equina syndrome, infection, compression fracture, and abdominal aortic aneurysm.
- Tumor
- Obviously cancer is a serious thing that we wouldn’t want to mistake for a simple muscle spasm. Although we can never 100% rule out a condition, there are some guides that we can follow to determine if something like a tumor should be suspected before proceeding with PT. By far the most important indicator to look at is if someone has had cancer in the past. Without a previous history of cancer a tumor suddenly showing up in the low back is much less common. Other factors to consider are is the pain affected by position or activity, are you over 50, has it not improved in the last 30 days despite trying exercises, do you have unexplained weight loss, and is there no relief with bed rest. Talk to your doctor if you have had any of these symptoms and especially if you’ve previously had cancer before.
- Cauda Equina Syndrome
- At the bottom of our spinal cord the nerves continue to exit down the spinal canal and exit out of holes between the vertebrae to go down our legs. It looks like a horse’s tail (hence the term cauda equina or horse tail in latin). Cauda equina syndrome is compression at this level of the spine that causes 4 main symptoms to look out for: unable to pee, loss of bowel control, numbness around the groin, and strength/sensation impairments to the feet. If you have any of these symptoms I would head to the emergency room immediately. It is most commonly from a massive disc herniation at the lower lumbar spine.
- Infection
- Have you recently had another type of infection (urinary or skin)? Or had intravenous drug use? And do you have a fever? Get check out for back related infection if you also have severe back pain.
- Spinal Compression Fracture
- This is an important one to look at how you were injured? Was it from a car accident, fall, or a direct blow to the spine? Especially those that are over the age 75 should be evaluated for a fracture. However, I would also caution those who have prolonged use of corticosteroids, have tenderness over the spine, and increased pain when standing.
- Abdominal Aortic aneurysm
- Does it feel like there is a pulse in your abdomen and have you previously or currently smoke? Especially age over 70 should be screened for abdominal aneurysm.
I empathize anyone going through a new onset of back low back pain. It can be a scary thing! However, the vast majority of low back pain cases do resolve and are not considered a serious medical condition. Most are sprains or strains. Hopefully looking at the above list above helps alleviate some fears and gets you on the path to recovery!