When to See a Doctor for Back Pain: 6 Red Flags

Key takeaways:

• Experiencing back pain does not always mean you need to see a healthcare provider.
• Loss of control over the bowel or bladder or weakness and loss of sensation in the legs are red-flag symptoms that require evaluation.
• Back pain that occurs as a result of a fall, injury, or motor vehicle accident should always be evaluated by a medical professional.

Back pain is one of the most common reasons for patients to seek medical care annually across multiple different specialties. While many cases of back pain are temporary and related to simple muscle strains or poor posture, some can signal more serious underlying medical and musculoskeletal concerns. Knowing when to see a doctor for back pain can make a significant difference in avoiding long-term complications. In this article, we will explore common red flags that indicate when back pain may require medical attention and whether you should visit your primary care provider, a specialist, or head to the emergency room.

When to make a doctor’s appointment or see a specialist for back pain

As mentioned above, not all cases of back pain require an appointment with a healthcare provider. However, there are a few symptoms to be on the lookout for that will indicate the need for medical attention.

1. Persistent pain

If your back pain lasts for more than a few days to a few weeks despite conservative home management measures, you should consult a doctor. Persistent or chronic back pain is categorized as pain lasting longer than three months and may indicate a deeper problem such as a herniated disc, spinal stenosis, or degenerative changes. Ignoring this pain could lead to permanent nerve damage or a worsening of the underlying issue and potentially result in limited mobility and the need for more invasive management methods.

2. Worsening pain

Just as with persistent pain, worsening pain over a short period of time also warrants medical attention. This is especially true if your pain worsens despite conservative management measures. Worsening pain can signal a progressing underlying condition that can lead to severe or permanent disability if not met with timely intervention. Some cases of worsening pain may also be the result of an infection that requires immediate antibiotic therapy.

3. Pain accompanied by numbness or weakness

Back pain that is accompanied by numbness, tingling, or weakness in the legs or arms should be taken seriously as these symptoms may suggest nerve involvement known as radiculopathy. Herniated discs in the neck and lower back, spinal stenosis, sciatica, and piriformis syndrome can all lead to nerve compression. Nerve involvement can lead to permanent nerve damage if not addressed in a timely manner.

4. Pain after an injury, fall, or motor vehicle accident

If your back pain is a result of a fall, injury, or motor vehicle accident, it is important to seek immediate medical attention. Ignoring back pain after a traumatic injury can delay the diagnosis of potentially serious conditions such as spinal fractures, spinal dislocations, and spinal cord injuries which require urgent medical treatment to prevent complications like paralysis or chronic pain. It is also important to point out that besides getting timely medical treatment, injuries that occur as a result of a motor vehicle accident must be seen within a certain window in order for the claim to be covered by car insurance.

5. Pain and loss of control over bowel or bladder

Cauda equina syndrome is a medical emergency that involves compression or damage to the bundle of nerves at the end of the spinal cord known as the cauda equina. These nerves control many important functions, including sensation and movement in the lower limbs, bladder, and bowels. When the cauda equina is compressed, it can lead to a range of serious symptoms, including burning lower back pain, numbness, weakness, and incontinence. If you are experiencing this symptom, it must be evaluated immediately in the emergency room.

6. Pain with unexplained weight loss

Back pain that is accompanied by unexplained weight loss, fever, or other systemic symptoms may signal a more serious health condition such as an infection like osteomyelitis (a bone infection) or spinal epidural abscess (a collection of pus around the spine and spinal cord) or even cancer. Cancer often metastasizes to the spine which is the third most common site of cancer metastasis in the body.

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

Deciding which medical facility to visit when you are experiencing back pain can be confusing. Knowing where to go for certain symptoms can help you receive timely and appropriate workup and treatment.

• You should see your primary care provider if you are experiencing ongoing mild to moderate pain that is not responding to conservative measures. Primary care providers can also assist patients experiencing chronic back pain who need a long-term treatment plan or prescription for therapy. Your doctor may also refer you to a specialist if needed.
• You should visit an urgent care if your pain is moderate but does not involve neurological or red-flag symptoms symptoms such as weakness, numbness, or loss of bladder or bowel control. Many urgent cares have the ability to order on-site X-rays, prescribe medication for pain relief and muscle relaxers, and may even be able to write a prescription for physical therapy or refer you to a specialist. Some urgent cares may even have the capability to see back pain that is the result of minor work-related injuries or motor vehicle accidents.
• If you are experiencing neurological symptoms, loss of control over the bowel or bladder, or if the pain is the result of a significant injury or motor vehicle accident, the emergency room is the most appropriate place to be seen.

How a doctor can help treat back pain

How a doctor will choose to manage your back pain will depend on the underlying cause, the severity, and what interventions have already been tried.

• Physical therapy is often recommended for strengthening the muscles around the spine, improving flexibility and mobility, and promoting better posture. This can be effective for individuals with chronic or recurring back pain or even in those with an acute muscle strain.
• Medications may include over-the-counter pain relievers such as ibuprofen or acetaminophen, prescription muscle relaxers, or even stronger pain medications if indicated.
• Surgery may be required in more severe cases, especially if there is nerve compression, herniated discs, significant fractures, or structural damage that cannot be treated with non-invasive methods.

Questions to ask your doctor about back pain

• What could be causing my back pain?
• Do I need imaging studies like an X-ray or an MRI?
• Will this pain be something that I experience for the rest of my life?
• Do all causes of back pain require surgery?

Frequently asked questions: when to see a doctor about back pain

Below are answers to some of the most frequently asked questions about when to see a doctor for back pain.

When should you see a doctor for back pain if you’re pregnant?

It is common to experience pregnancy-related back pain due to weight gain, increased pressure on the pelvis, and hormonal changes that lead to ligament laxity. Many pregnant people even experience radiculopathy, or pain and tingling that radiates down the leg due to sciatica.

Although back pain is somewhat expected and normal during pregnancy, any pregnant person experiencing back pain should still speak with their healthcare provider to rule out any other possible causes of pain.

When should you see a doctor for upper or lower back pain?

You should consult a doctor if upper or lower back pain is severe, persistent, or accompanied by other symptoms like weakness, numbness, or difficulty with bowel and bladder control. Any pain that is sudden-onset without an obvious cause should also be evaluated.

Conclusion

Back pain can range from a minor inconvenience to a serious condition requiring medical intervention. Recognizing the red flags that indicate when to see a doctor will help when it comes to deciding whether or not you need to be seen and by whom. If you experience severe, persistent, or worsening back pain, or have any of the red-flag symptoms reviewed throughout this article, it is important to consult with a healthcare provider as soon as possible to get relief and avoid future complications.

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. Lane Thaut, DO.

Sources

Alexander, Christopher E., et al. “Lumbosacral Radiculopathy.” StatPearls, StatPearls Publishing, 27 February 2024. https://pubmed.ncbi.nlm.nih.gov/28613587/

“Low Back Pain.” Www.hopkinsmedicine.org, 9 June 2022, www.hopkinsmedicine.org/health/conditions-and-diseases/back-pain/low-back-pain. Accessed2 Dec. 2024.

Rider, Loana S. and Erin M. Marra. “Cauda Equina and Conus Medullaris Syndromes.” StatPearls, StatPearls Publishing, 7 August 2023. https://pubmed.ncbi.nlm.nih.gov/30725885/

Tse, Victor. “Spinal Metastasis: Background, Pathophysiology, Prognosis.” EMedicine, Nov. 2019, emedicine.medscape.com/article/1157987-overview. Accessed 2 Dec. 2024.