Serious back pain

What is serious back pain?

It is very uncommon to experience what we call serious back pain. Most cases of back pain can be resolved through self-management and keeping active.

However, in a small minority of cases, the symptoms indicate potentially more serious issues, which should be referred to a medical professional without delay.

This section is designed to help you identify if you need a medical assessment.

What causes serious back pain?

Your spine is a very robust and resilient structure, but it is also extremely complex.

Certain symptoms can suggest that the cause of your back pain could be something that needs an urgent opinion from a health care professional. Sometimes that opinion is needed immediately, the same day. In other cases, it is just needed urgently.

If you have suffered a recent injury to the spine, for example in a car accident, a fall from height or a direct blow to the back, you are advised to check the symptoms listed here and seek medical advice if any of these develop.

If you are not aware of a specific injury or trauma but you have concerns that have not been answered on our other pages, also check the symptoms listed here.

Please do remember, however, that many other things can cause these symptoms and serious back problems are actually extremely rare.

What are the symptoms of serious back pain?

The following symptoms require an urgent, same day opinion at your local A&E. Seek help immediately if you have both back and leg pain, plus any of these:

• Loss of feeling/pins & needles between your inner thighs or genitals.
• Numbness in or around your back passage or buttocks.
• Altered feeling when using toilet paper to wipe yourself.
• Increased difficulty when you try to urinate.
• Increased difficulty when you try to stop or control your flow of urine.
• Loss of sensation when you pass urine.
• Leaking of urine or recent need to use pads.
• Not knowing when your bladder is either full or empty.
• Inability to stop a bowel movement or leaking.
• Loss of sensation when you pass a bowel motion.
• Change in ability to achieve an erection or ejaculation.

It is vitally important that you act immediately if you develop the symptoms above, as they could be an indication of a rare condition called Cauda Equina Syndrome (CES). Delaying a medical assessment could seriously impact your long-term health.

The following symptoms require an urgent same day appointment with your GP. Seek help quickly from a healthcare professional, such as your GP, if you have any of these:

• Back pain that is growing worse, severe and different to your normal experience of pain.
• Back pain that spreads like a band around your body, stomach area or trunk, or that spreads into your lower back, buttocks, or legs.
• Odd feelings in your legs with the feeling of unsteadiness.
• Altered sensation/pins & needles in both legs/feet.
• Difficulty walking and heaviness in your legs.
• Back pain that stops you sleeping at night or gets worse when lying down.
• Fever or chills that came on around the same time as your back pain.
• Night sweats.
• Back pain accompanied by sudden unexplained weight loss or a general feeling of being unwell.
• A change in the appearance or angle of your back/spine.

Note: If you have been diagnosed with cancer, or have a history of cancer, and you have any of the above symptoms, you should seek medical advice immediately.

How is serious back pain diagnosed?

Serious back pain is not a condition in itself but may indicate other causes. Your doctor will assess your symptoms, carry out an examination and advise you on whether you need further investigations.

What are the treatment options for serious back pain?

This depends on the cause. Your doctor will advise you.

What is the prognosis (outlook) for serious back pain?

Again, this depends on the cause and your doctor will advise you.