When to Go to Urgent Care for Back Pain: 4 Red Flags

Key takeaways:

• Most back pain does not require urgent care. Common causes like muscle strain or arthritis can often be managed with home care or a doctor’s visit.
• Seek urgent care if certain serious symptoms occur. Go to urgent care if your back pain is accompanied by trauma, numbness, weakness, incontinence, fever, or unexplained weight loss.
• When unsure, call for guidance. If you’re not sure whether your symptoms need urgent care, contact your doctor or a hospital nurse line to help decide the next steps.

Back pain is a common symptom. It is estimated that nearly 40% of Americans will suffer back pain in any three-month period. This is a frustrating and often activity-limiting experience.

Many times, back pain is due to a mechanical cause. This means the pain comes from the muscles, bones, or other soft tissue in our back. Often, the problem is related to sprains, strains, or even arthritis.

But there are times when back pain has a more serious cause. The key is knowing what signs and symptoms to look for. Let’s review when your back pain should lead you to seek more immediate care.

When to go to urgent care for back pain

There are times when back pain isn’t mechanical in nature. It may be that the cause of your back pain is something more serious. Let’s go over some of these.

1. Trauma

If you have recently experienced trauma, this can be a cause of your back pain. Trauma is more than just a car or motorcycle accident. It can be something as insignificant as a fall from standing height. It could even be that you bumped your back on a hard surface or object.

Trauma is a risk for fracture of the bony parts of your spinal cord. Some conditions put you at greater risk for a fracture. These include osteoporosis, age greater than 70 years, or steroid use. This is also more likely if you are feeling pain at a particular point on your back.

If you have experienced trauma and are now having back pain, call your doctor. They may want you to proceed to the emergency room or urgent care.

2. Numbness, weakness, or incontinence

Back pain accompanied by numbness or leg weakness is a definite red flag. Another symptom to watch out for is loss of control of the bladder or bowels. This combination of symptoms indicates pressure on the lower part of the spinal cord.

Many conditions can put pressure on the lower spinal cord. Tumors, infections, and structural problems of the cord itself are just a few such conditions.

If you are having back pain and leg numbness or weakness, or if you have lost control of your bowels or bladder, this is an emergency. You should proceed directly to the emergency room.

3. Weight loss

If you have been losing weight while experiencing back pain, this can be a sign of an underlying infection. It can also indicate the presence of a tumor. This is more likely if you have a history of cancer.

Certain cancers are more likely to spread to the spinal cord. These include breast, lung, prostate, and kidney.

If you have been experiencing back pain and unintended weight loss, call your doctor or go to urgent care.

4. Fever

In certain instances, back pain and fever come together. This often indicates infection. There are specific risk factors for these conditions. One risk factor is having had spinal surgery in the last year. If you have had spinal surgery or even a spinal procedure in the past year and are running a fever, please call the surgeon who performed the procedure. You may need to be admitted to the hospital or have another procedure performed.

Another risk factor for infection is intravenous drug abuse. When needles are used to administer drugs into the veins, there is a risk of infection. If you have recently used drugs intravenously and now have back pain, please call your doctor or go to the emergency room. The infection can spread from your spine to other parts of the body. This can be a life-threatening situation.

Going to urgent care, a doctor’s appointment, or the emergency room for back pain

If you are unclear which is best for you, call your doctor. If your doctor’s office is closed, call the nearest hospital. Hospitals frequently have nurses available by phone. They can help you select the appropriate level of care.

How urgent care can help treat back pain

An urgent care facility often has more resources than a doctor’s office. They can provide initial stabilization and frequently have access to advanced imaging and lab studies. If it is needed, they can facilitate transporting you to an emergency room.

Red flag evaluation

One of the most important parts of being evaluated for back pain is looking for “red flags.” These are the signs or symptoms that can indicate a more serious problem might be present. If it is determined one of these problems could be present, there are several possible courses of action:

• Advanced imaging may be necessary to better understand what is happening. This could include a CT scan (“cat scan”) or an MRI. Your urgent care facility may have these devices on hand. You might also be referred or sent to a facility with these capabilities.
• Emergency referral to a hospital with the proper specialists may be necessary. If you had a spinal surgery or procedure performed, you may need to return to that facility.
• Urgent outpatient referral to a specialist. This will depend on the nature of the problem you are diagnosed with.

Pain medication

To provide initial pain relief, an urgent care doctor can prescribe medications only available in hospitals. These can be stronger than what is normally available at most doctor’s offices.

If you are sent home from urgent care, your doctor may prescribe pain medications. Your urgent care doctor may prescribe something stronger than what’s available over the counter. Take it as prescribed and only as long as needed.

Physical therapy

Physical therapy may be prescribed to you. This is usually in cases when the pain is due to musculoskeletal injury or weakness. The goal of physical therapy is to strengthen the musculoskeletal system around your back to prevent future injury.

Questions to ask your urgent care providers about back pain

• What is the cause of this pain?
• What are the signs or symptoms that it’s serious?
• Can I do anything to prevent this?
• When should I call you if I’m not feeling better?

Frequently asked questions: going to urgent care for back pain

It is normal to have questions. Please ask any questions you have until you understand your condition.

How bad should your back pain be before you go to urgent care?

If your pain is severe enough that it is preventing you from completing your normal daily activities, you should go to urgent care.

How can urgent care help treat lower back pain?

An urgent care facility can evaluate you for any of the more serious causes listed above. If present, they can make appropriate referrals for treatment. If not, they can prescribe pain medication and other therapies to help you feel better.

Managing back pain

Rest assured that most of the time, back pain is not due to a serious medical condition. There are certain signs and symptoms of this, however. If you are unsure, call your doctor and ask.

General Medicine follows a strict editorial process, including using real experts to write our articles, vetted primary sources, fact-checking, a secondary medical review, and updates as necessary. This article was medically reviewed and fact checked by Dr. Poushali Bhattacharjee, MD.

Sources

CDC. “Products - Data Briefs - Number 415 - July 2021.” Www.cdc.gov, 7 Dec. 2021, www.cdc.gov/nchs/products/databriefs/db415.htm.

Casiano, Vincent E, et al. “Back Pain.” Nih.gov, StatPearls Publishing, 11 Dec. 2023, www.ncbi.nlm.nih.gov/sites/books/NBK538173/.

Ziu, Endrit, et al. “Cancer, Spinal Metastasis.” PubMed, StatPearls Publishing, 2020, www.ncbi.nlm.nih.gov/books/NBK441950/.