The underlying causes for most occurrences of back pain are non-emergent, but the intense pain and related symptoms often elevate anxiety and prompt a visit to the emergency room (ER). While back pain is typically treated in a primary care setting or by a musculoskeletal specialist, physicians are often cautious and look for warning signs of neurologically impairing or life-threatening causes. These causes are rare, but if present, they are considered a medical emergency and warrant immediate treatment to preserve back and/or leg function. Show
Though rare, acute cauda equina syndrome is a serious medical emergency. It usually requires immediate medical attention. Watch Cauda Equina Syndrome Video Back pain is considered the most common musculoskeletal cause for emergency room visits and typically involves individuals aged 18 to 65 years.1,2 This article provides a comprehensive guide to when back pain may indicate a medical emergency and the associated red-flag symptoms to watch out for. advertisement When an Emergency Room Visit Is Warranted for Back PainWhen dealing with severe back pain, making a judgment call about whether to seek help in a doctor’s office or visit the ER may be difficult. The following list describes the symptoms and signs related to conditions that may have resulted in spinal cord, cauda equina, or internal organ damage, which are typically considered as a medical emergency. Abdominal aortic aneurysmLower back pain that radiates to the front abdomen may occur together in a rare, serious medical condition called abdominal aortic aneurysm. Classic symptoms include:
Abdominal aneurysms are more prevalent among men aged 65 to 75 years who smoke cigarettes.3 See Abdominal Aortic Aneurysm Causes Cauda equina syndromeDamage to the cauda equina nerves can cause cauda equina syndrome, a condition that results in severe impairments in the lower back and leg(s). The hallmark symptoms of this condition include:
Cauda equina syndrome may occur as a result of acute trauma or develop without an inciting event, due to the progression of an underlying condition. These conditions may include a lumbar herniated disc, lumbar spinal stenosis, or spinal tumor that affects the cauda equina nerves. Read more about Causes of Cauda Equina Syndrome In This Article:Spinal tumorBenign or metastatic spine tumors may cause back pain as the first symptom. Over time, they are typically accompanied by other distinguishing symptoms, such as:
Tumors can originate in the spine or spread to the spine from other parts of the body, in which case they are more likely to lodge in the vertebrae because of the spine’s extensive network of blood vessels. The back and leg symptoms are typically dictated by the location of the tumor in the spine. See Could My Back Pain Be Spine Cancer? Spinal infectionHarmful microorganisms can travel to the spine from other parts of the body where infection exists. The resulting spinal infection, called vertebral osteomyelitis, can result in back pain. The symptoms of a spinal infection are variable and depend on the age of the patient, the severity of the infection, and the location in the spine. In addition to back pain, spinal infection symptoms may include some combination of the following:
A spinal infection may move into the spinal canal and cause an epidural abscess, which can place pressure on the neural elements, such as the spinal cord, cauda equina, and/or spinal nerve roots. Depending on the level of infection and/or the degree of severity, sciatica-like symptoms, such as numbness, weakness, or paralysis, may occur in the areas of the body below the affected site. See Osteomyelitis Treatments Acute traumaBack pain that occurs immediately after acute trauma to the upper or lower back prompts urgent evaluation. Examples of acute trauma include sudden injuries from events like a slip, fall, playing active sports, or motor vehicle accident. Moderate to severe back pain may develop as the only symptom or may occur in tandem with neurological symptoms, such as:
Injuries from acute trauma to the back can result in a spinal fracture or severe spondylolisthesis, which can compress or injure the spinal cord and/or cauda equina at the level involved. If an underlying bone-weakening condition, such as osteoporosis, exists, even mild trauma may cause compression fractures in the spine. advertisement Who May Be Prone to Back Pain from Medical EmergenciesWhile a serious medical condition can affect anyone, some individuals are more prone to these problems due to their underlying health conditions, physical characteristics, and lifestyle habits. This list outlines the groups of people most prone to back pain from medical emergencies:
As a general rule, any concerning symptom or sign needs to be evaluated by a medical professional. A trained medical professional can adequately evaluate the vital signs, prescribe the necessary diagnostic tests, identify potential neurologic defects, and uncover any red flags. Physicians can also provide timely treatment to prevent the progression of the condition, avoiding permanent damage to the tissues. See When to Seek Medical Care for Low Back Pain References
Why does my upper stomach hurt and back?Pancreatitis, or inflammation of the pancreas, can cause upper abdominal pain in addition to back pain, along with vomiting or nausea. Both forms of pain tend to be reduced when you lean forward and to become worse when irritated, especially by sharp movements like coughing.
When should I worry about upper abdominal pain?Pain in your upper abdomen is usually due to a temporary, minor problem, such as indigestion or gas. However, ongoing or severe upper abdominal pain may indicate a potentially serious condition. Contact a doctor for severe pain or pain that does not go away within 2 days.
Why is my lower back and abdomen paining?Lower back pain that radiates to the front abdomen may occur together in a rare, serious medical condition called abdominal aortic aneurysm. Classic symptoms include: A continuous, stabbing pain of severe intensity felt deep in the abdomen between the sternum in the center of the chest and the belly button.
What part of back hurts with pancreatitis?Mid-back pain can be a sign of pancreatic cancer. The pain can be caused by a tumour invading nerves or organs that lie near the pancreas. Some people also report that they feel pain in their shoulder or under their shoulder blade. Other people feel pain in their back and abdomen (tummy) at the same time.
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