When does a back pain need medical attention?

All back pains are not routine strains. Early diagnosis of any serious condition makes the treatment easier.

Back and neck pain are very common symptoms. Almost all of us would have experienced an episode of significant back pain by the age of 40 – 50 years. And we also know that most of the times, it is due to a strain or minor injury and it usually gets better with some rest and medications.

But, we must remember that back pain could be a symptom of a more serious problem in the spine sometimes. Ignoring the back pain for too long can affect the diagnosis and recovery.

So, when should one consider a back pain or neck pain more serious than a simple strain?

The following points help as indicators of a more serious cause for the back pain:

Pain at rest or night pain/sleep disturbance due to pain:

The usual mechanical back pain gets better with rest and is unlikely to disturb sleep.

Any back or neck pain that is not relieved by rest or wakes you up from sleep in the night should be considered as serious. It needs medical attention and relevant imaging of the spine.

Duration of pain:

Any pain that persists for more than 4 weeks despite usual measures like rest, physiotherapy and medication needs further evaluation.

Age:

As one ages, the risk of tumours in various organs of the body increases. Some of the tumours are aggressive and can spread through the blood stream (metastasis) to the bones as well as other organs. Spine is the most common location of such spread. Any person over the age of 50 years with persistent back or neck pain should undergo a clinical evaluation and imaging if required based on the examination.

Any one with a prior history of cancer developing a back pain should be evaluated immediately to rule-out a spinal metastasis.

Unexplained weight loss:

Any weight loss of more than ten percent of body weight in less than six months of time is considered as significant. An unexplained weight loss could be due to a cancer or infection and needs a thorough evaluation.

Compromised immunity:

Conditions that impair the immunity like diabetes, prolonged steroid intake etc could lead to infection in the spine that could be the cause of back pain. So back pain in immunocompromised patients, especially if associated with fever or weight loss or loss of appetite are considered as red flags and needs immediate further evaluation.

Weakness or numbness:

Inability to walk due to weakness in major muscles of lower limbs, numbness (loss of sensation) or paraesthesias ( tingling or pins & needles sensation) in the limbs or in the perianal region, loss of bladder or bowel control – all indicate a possible spinal cord or nerve root compression in the spine. The cause for such neurological deficit needs to be immediately identified and treated accordingly.

Smoking:

Current or past smokers are at a high risk of developing cancer. They are also at risk of osteoporosis and thereby osteoporotic vertebral fractures.

Trauma:

Significant trauma in young individuals can cause a fracture in the spine. In the elderly, the bones are weak and can easily fracture.

Even a trivial fall at home can cause a fracture in the elderly, especially in women. Any history of osteoporotic fracture in the past is also significant in this scenario.

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Dr Phani Kiran S

Experience and Professionalism

With years of experience in spine surgery, Dr Phani Kiran S, Senior Consultant Spine Surgeon will assess you and suggest the treatment option that is right for you.

We at Medspine clinics, understand the importance of educating all our patients about the spinal problems and the most effective ways to take care of their spine.