There are a number of potential causes of back pain, but most of them are rare. Most cases of back pain, particularly those that go away with or without over-the-counter treatment, do not require a visit to the doctor. However, if your back pain is accompanied by any of the following signs and symptoms, a trip to your doctor’s office is probably a good idea. The symptoms you are having could indicate a serious problem that may require immediate medical treatment.
Although an achy back could be due to flu, back pain with a fever that is unresponsive to over-the-counter medications could also be a sign of a serious systemic infection.
You can see your primary care provider for proper diagnosis and treatment. If you have an infection, your doctor may prescribe antibiotics along with recommending rest for a couple of days. Resting more than two days can actually make the pain worse instead of feeling better.
2. Numbness and Tingling Sensations
If your back pain is always accompanied by these sensations, it would be better to see your primary care provider for an evaluation.
Numbness or tingling often indicates nerve damage or irritation. If you continue to experience these sensations, you may have certain conditions that cause nerve pressure, such as spinal stenosis and a herniated disc. If these conditions are left untreated, they can lead to permanent disabilities.
Both relatively minor and serious trauma must be evaluated by a doctor, especially if you are more than 50 years old. Your healthcare provider may order an X-ray to see if you have fractures. In the absence of fractures, treatment usually involves pain medications and physical therapy later on your recovery.
4. Loss of Bladder or Bowel Control
When back pain is accompanied along with bladder or bowel control, it could indicate a serious but rare medical condition called cauda equina syndrome (CES). This condition is caused by nerve root compression and paralysis in the lower portion of the spinal cord. It often occurs as a result of a tumor, fracture, spinal cord injury, spinal stenosis, or a herniated disc.
The symptoms of cauda equina syndrome include leg weakness and numbness, which can develop over time. However, CES is considered a medical emergency, which requires immediate medical attention. Treatment for CES involves a procedure called surgical decompression, which helps relieve the pressure that damages the nerves.
5. History of Cancer, Osteoporosis, Immune Deficiency, or Chronic Use of Steroids
Doctors would want to rule out cancer, especially in patients who have a history of cancer and complain about a persistent back pain. An infection may also be suspected as the cause of back pain if you are immunocompromised or have a weak immune system. If you have a history of prolonged steroid use or osteoporosis, your doctor might suspect a fracture as the main cause of your back pain.
To rule out any infections or tumors, your healthcare provider may order blood tests or an MRI scan. An X-ray test can also be done to help rule out fractures. Infections are usually treated using antibiotics while fractures are managed using a combination of medications, physical therapy, and in some cases, surgery.
For cancer that has already spread to the spine, treatment for pain may include both medications and radiotherapy (radiation therapy).
6. Unintentional Weight Loss
People who complain about a persistent aching back along with an unexplained weight loss may warrant a visit to the doctor to rule out possible infections or tumors.
To check for any infection or tumor, your doctor may order blood tests or an MRI scan. If these tests turn out negative, pain medication may be prescribed along with physical therapy. Other tests may be ordered to further identify the cause of your unintentional weight loss.
7. Night Back Pain
Back pain at nighttime that causes difficulty sleeping could indicate a sprain, disc degeneration, or something more serious like a tumor or cancer. For this reason, an aching back at nighttime should never be ignored. Schedule a doctor’s appointment right away.
8. Persistent Pain (More than 6 weeks)
Most cases of back pain go away after a period of six weeks. If you continue to experience back pain beyond this point, your doctor would want to check for other serious underlying causes of your back pain.
9. Foot Drop
Foot drop is a type of paralysis or muscular weakness that affects the toes and the front part of the foot. Foot drop is often a sign of a medical problem instead of being a condition itself and can be accompanied by back pain. It can be a symptom of a nerve or muscle problem. If a herniated disc is the underlying cause, your doctor may recommend steroid injections along with physical therapy.
10. Intravenous Drug Use
Both legal and illicit drugs can be abused through IV drug use and can create a number of health concerns or complications. People who use IV drugs for a long period of time have an increased risk of developing infections. If your back pain is due to an infection, your healthcare provider will most likely prescribe antibiotics along with pain medications.
11. Old Age
Back pain is one of the most common disabling conditions among people who are 70 years old or older. Older adults are also more prone to developing infections and tumors, including stomach and back pain problems.
When to See a Doctor
It's time to visit your doctor if your back pain still persists after one week of home treatment and if your aching back is accompanied by the following symptoms:
- Redness or swelling on your back
- Unexplained weight loss
- Numbness, tingling, or weakness in one or both of your legs
- Intense pain at night, especially when lying down
- Pain that spreads below your knees
Which Type of Doctor Should I See?
There are different types of healthcare providers who can treat back pain. However, it is best to see your primary care doctor first. Your doctor may also refer you to a specialist if he or she thinks it is necessary for your condition. You may be referred to the any of the following specialists:
- Physical therapists
- Occupational therapists
- Clinical psychologists