Table of ContentsView AllTable of ContentsAgeFever, Ilness, or SurgeryTraumaHistory of CancerNight PainIncontinenceWeak Leg Muscles
Table of ContentsView All
View All
Table of Contents
Age
Fever, Ilness, or Surgery
Trauma
History of Cancer
Night Pain
Incontinence
Weak Leg Muscles
Back pain is very common—four out of five people experience it at some point in their lives.Most of the time back pain isn’t serious; other times it may indicate a larger health problem, so it’s important to know about back pain red flags.
Some of the most serious conditions that can lead to upper, lower, or middleback paininclude spinal infection, cancer, and a problem known ascauda equinasyndrome. That’s when compressed nerve roots cut off sensation and movement.
If you experience pain associated with these conditions, talk to your healthcare provider as soon as possible.
The back pain red flags listed below may indicate a serious medical condition, or they may be unrelated to your back pain. Only a healthcare provider will be able to tell the difference, so it’s important to bring any symptoms you have to your healthcare provider’s attention.
If you are younger than 18 or older than 50, acute back pain may be cause for concern.
Back pain in people younger than 18 without a history of trauma may indicate a stress fracture in a vertebra. Gymnasts, weight lifters, and other athletes who experience repeated stress to the lower back are susceptible to this kind of injury.
In some situations, pain in young people may be a sign of a spinal tumor orcancer. Signs to watch for:
If you are older than 50, new back pain may signal a number of potential conditions, including a tumor or spinal infection.
New back pain may also indicate an issue with internal organs such as :
Fever, Chills, or Recent Illness or Surgery
Types of infection that cause back pain include:
Spinal epidural abscesses can occur in people who have boils or infections in the bloodstream or bones of the spine.It may also occur in those who have recently had back surgery. People who use intravenous drugs are also at increased risk for spinal epidural abscess.
A recent lumbar puncture during surgery or an epidural injection to help with back pain, for example, may increase the risk of an infection or epidural hematoma (pooling of blood on the outer covering of the brain or spinal cord and nerve roots).
With a spinal infection, it is imperative to get an accurate diagnosis as quickly as possible.
Treatment focuses on eliminating the infection and relieving pain. Improved nutrition can boost yourimmune systemthrough overall diet changes. Or it can add specific nutrients, like vitamin D and calcium to prevent bone loss due toosteoporosis, which can lead to complications like infection after a spinal injury.
These strategies may be part of a treatment plan to maintain spinal stability and to preserve and restore the function of your nervous system.
Major trauma, such as a bad car accident, significant fall, or sports injury, may result in a fracture of the spine. A vertebral fracture may additionally injure surrounding nerves or the spinal cord itself.
However, even minor trauma can be cause for concern, particularly if you are older than 50 or have (or are at risk for)osteopenia,osteoporosis, cancer, or another condition that weakens the bones.
Reaching, twisting, or falling from standing height are examples of minor trauma that may damage the spine.
If you are usinganticoagulant medication, trauma can also result in an epidural hematoma. If this is the case, you may have back pain, weakness, or tingling in your arms or legs.
If you currently have cancer or had it in the past, back pain may indicate a recurrence ormetastasis, where the cancer has spread to other parts of the body.
Back pain that worsens over several months, unexplained weight loss, and pain at night or at rest may also indicate cancer.
Some types of cancers are especially likely to put pressure on the spine. Spinal cord compression is a common complication of the following cancers:
Patients with metastatic bone cancer may also develop epidural spinal compression.
Night Pain or Pain at Rest
Experiencing back pain at night or at rest can be (but isn’t necessarily) a sign of a serious condition such as an infection or cancer.
This is particularly true if your night or resting back pain occurs alongside another symptom. For example, pain at night and recent weight loss, especially in adolescents, are red flags for cancer and warrant a visit to your healthcare provider.
Incontinence and Saddle Anesthesia
Soiling yourself without realizing it, numbness in your groin or inner thigh, or both may be signs of nerve problems, including cauda equina syndrome.
In this syndrome, compressed nerve roots in the lumbar spine cut off sensation and movement in the buttocks and inner thighs (known as saddle anesthesia). Loss of feeling and paralysis can become permanent without quick treatment.
Other common symptoms of cauda equina include:
Cauda equina syndrome can result in serious damage to your health—including paralysis. As such, symptoms of cauda equina warrant immediate medical attention.
Weak, Numb, or Painful Leg Muscles
Your healthcare provider may test the strength of both your legs, particularly if your back pain came on suddenly and you are experiencing nerve pain. Weakness in your legs may indicatesciaticaornerve compression.
If you experience back pain often and the strength of your lower limbs has become weaker, it may be a sign of serious neurological damage.
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Summary
16 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.MedlinePlus Medical Encyclopedia.Back pain.Orthoinfo - American Academy of Orthopaedic Surgeons.Spondylolysis and spondylolisthesis.Cedars-Sinai.Spinal tumors.MedlinePlus.Kidney stones.MedlinePlus Medical Encyclopedia.Abdominal aortic aneurysm.National Pancreas Foundation.Acute pancreatitis.Johns Hopkins Medicine.Gallstones.American Association of Neurological Surgeons.Spinal infections.MedlinePlus.Epidural abscess.MedlinePlus Medical Encyclopedia.Epidural hematoma.Abdelrahman S, Ireland A, Winter EM, Purcell M, Coupaud S.Osteoporosis after spinal cord injury: Aetiology, effects and therapeutic approaches.J Musculoskelet Neuronal Interact.2021;21(1):26-50.Downie A, Williams CM, Henschke N, et al.Red flags to screen for malignancy and fracture in patients with low back pain: Systematic review.BMJ. 2013;347(dec11 1):f7095-f7095. doi:10.1136/bmj.f7095Robson P.Metastatic spinal cord compression: A rare but important complication of cancer.Clin Med (Lond). 2014;14(5):542-545. doi:10.7861/clinmedicine.14-5-542American Association of Neurological Surgeons.Cauda equina syndrome.Johns Hopkins Medicine.Sciatica.Siddiq MAB, Clegg D, Hasan SA, Rasker JJ.Extra-spinal sciatica and sciatica mimics: A scoping review.Korean J Pain. 2020;33(4):305-317. doi:10.3344/kjp.2020.33.4.305Additional ReadingDePalma MG.Red flags of low back pain.Journal of the American Academy of Physician Assistants. 2020;33(8):8-11. doi:10.1097/01.JAA.0000684112.91641.4cNorth American Spine Society.Spinal infections.
16 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.MedlinePlus Medical Encyclopedia.Back pain.Orthoinfo - American Academy of Orthopaedic Surgeons.Spondylolysis and spondylolisthesis.Cedars-Sinai.Spinal tumors.MedlinePlus.Kidney stones.MedlinePlus Medical Encyclopedia.Abdominal aortic aneurysm.National Pancreas Foundation.Acute pancreatitis.Johns Hopkins Medicine.Gallstones.American Association of Neurological Surgeons.Spinal infections.MedlinePlus.Epidural abscess.MedlinePlus Medical Encyclopedia.Epidural hematoma.Abdelrahman S, Ireland A, Winter EM, Purcell M, Coupaud S.Osteoporosis after spinal cord injury: Aetiology, effects and therapeutic approaches.J Musculoskelet Neuronal Interact.2021;21(1):26-50.Downie A, Williams CM, Henschke N, et al.Red flags to screen for malignancy and fracture in patients with low back pain: Systematic review.BMJ. 2013;347(dec11 1):f7095-f7095. doi:10.1136/bmj.f7095Robson P.Metastatic spinal cord compression: A rare but important complication of cancer.Clin Med (Lond). 2014;14(5):542-545. doi:10.7861/clinmedicine.14-5-542American Association of Neurological Surgeons.Cauda equina syndrome.Johns Hopkins Medicine.Sciatica.Siddiq MAB, Clegg D, Hasan SA, Rasker JJ.Extra-spinal sciatica and sciatica mimics: A scoping review.Korean J Pain. 2020;33(4):305-317. doi:10.3344/kjp.2020.33.4.305Additional ReadingDePalma MG.Red flags of low back pain.Journal of the American Academy of Physician Assistants. 2020;33(8):8-11. doi:10.1097/01.JAA.0000684112.91641.4cNorth American Spine Society.Spinal infections.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
MedlinePlus Medical Encyclopedia.Back pain.Orthoinfo - American Academy of Orthopaedic Surgeons.Spondylolysis and spondylolisthesis.Cedars-Sinai.Spinal tumors.MedlinePlus.Kidney stones.MedlinePlus Medical Encyclopedia.Abdominal aortic aneurysm.National Pancreas Foundation.Acute pancreatitis.Johns Hopkins Medicine.Gallstones.American Association of Neurological Surgeons.Spinal infections.MedlinePlus.Epidural abscess.MedlinePlus Medical Encyclopedia.Epidural hematoma.Abdelrahman S, Ireland A, Winter EM, Purcell M, Coupaud S.Osteoporosis after spinal cord injury: Aetiology, effects and therapeutic approaches.J Musculoskelet Neuronal Interact.2021;21(1):26-50.Downie A, Williams CM, Henschke N, et al.Red flags to screen for malignancy and fracture in patients with low back pain: Systematic review.BMJ. 2013;347(dec11 1):f7095-f7095. doi:10.1136/bmj.f7095Robson P.Metastatic spinal cord compression: A rare but important complication of cancer.Clin Med (Lond). 2014;14(5):542-545. doi:10.7861/clinmedicine.14-5-542American Association of Neurological Surgeons.Cauda equina syndrome.Johns Hopkins Medicine.Sciatica.Siddiq MAB, Clegg D, Hasan SA, Rasker JJ.Extra-spinal sciatica and sciatica mimics: A scoping review.Korean J Pain. 2020;33(4):305-317. doi:10.3344/kjp.2020.33.4.305
MedlinePlus Medical Encyclopedia.Back pain.
Orthoinfo - American Academy of Orthopaedic Surgeons.Spondylolysis and spondylolisthesis.
Cedars-Sinai.Spinal tumors.
MedlinePlus.Kidney stones.
MedlinePlus Medical Encyclopedia.Abdominal aortic aneurysm.
National Pancreas Foundation.Acute pancreatitis.
Johns Hopkins Medicine.Gallstones.
American Association of Neurological Surgeons.Spinal infections.
MedlinePlus.Epidural abscess.
MedlinePlus Medical Encyclopedia.Epidural hematoma.
Abdelrahman S, Ireland A, Winter EM, Purcell M, Coupaud S.Osteoporosis after spinal cord injury: Aetiology, effects and therapeutic approaches.J Musculoskelet Neuronal Interact.2021;21(1):26-50.
Downie A, Williams CM, Henschke N, et al.Red flags to screen for malignancy and fracture in patients with low back pain: Systematic review.BMJ. 2013;347(dec11 1):f7095-f7095. doi:10.1136/bmj.f7095
Robson P.Metastatic spinal cord compression: A rare but important complication of cancer.Clin Med (Lond). 2014;14(5):542-545. doi:10.7861/clinmedicine.14-5-542
American Association of Neurological Surgeons.Cauda equina syndrome.
Johns Hopkins Medicine.Sciatica.
Siddiq MAB, Clegg D, Hasan SA, Rasker JJ.Extra-spinal sciatica and sciatica mimics: A scoping review.Korean J Pain. 2020;33(4):305-317. doi:10.3344/kjp.2020.33.4.305
DePalma MG.Red flags of low back pain.Journal of the American Academy of Physician Assistants. 2020;33(8):8-11. doi:10.1097/01.JAA.0000684112.91641.4cNorth American Spine Society.Spinal infections.
DePalma MG.Red flags of low back pain.Journal of the American Academy of Physician Assistants. 2020;33(8):8-11. doi:10.1097/01.JAA.0000684112.91641.4c
North American Spine Society.Spinal infections.
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