Back Symptoms that Indicate a Medical Emergency

We talk a lot about how most back problems can be successfully managed without back surgery, and how exercise and a healthy lifestyle can help keep your back healthy too. While this is true for most cases of back pain, there are times when back pain-related symptoms are a sign of a serious medical problem. Therefore, we thought it would be useful to discuss a number of symptoms that may indicate a medical emergency.

Progressive Weakness, Sensory Deficits or Loss of Bladder or Bowel Control

Anyone who has sudden onset of bladder and/or bowel incontinence (that causes you to retain urine or be unable to hold it, or in rare cases lose rectal control), and/or progressive weakness in the lower extremities should seek immediate medical attention. Both of these are primary symptoms of a serious condition called Cauda equina syndrome. Typical symptoms include:

• Severe or progressive weakness, numbness or altered sensation in the lower extremities - the legs and/or feet
• Loss of sensation or altered sensation in the “saddle” area (the area or your body that would sit on a saddle: inner thighs/between the legs, buttocks, back of legs, sacral region)
• Pain, numbness or weakness in one or both legs that may cause you to stumble or have difficulty walking.

Cauda equina syndrome is caused by compression of the nerves in the lower spine, which can happen from a trauma to the spine, any spinal condition that may compress the nerves (such as a disc herniation, spinal stenosis), or an infection. Left untreated, this syndrome can ultimately result in paralysis, as well as continued loss of sensation in areas below the lower spine. For more information, see the following article:

• Lower back pain.

Unexplained Weight Loss, Loss of appetite, Pain and Neurological Problems

If you’re on a diet and have started exercising, then you would expect to lose weight. However, if someone’s weight has been steady for a long time and for no known reason there is now weight loss and/or lack of appetite, it may be indicative of a serious medical condition, such as cancer. Several symptoms of a tumor in the spine include:

• Pain in the neck or back, followed by neurological problems (such as weakness or numbness of the arms or legs or a change in normal bowel or bladder habits) is most common
• Back pain that does not diminish with rest, and pain that may be worse at night than during the day
• Any of the above symptoms along with loss of appetite, unplanned weight loss, nausea, vomiting, or fever, chills or shakes

For more information, see the following articles:

• Could my back pain be cancer?
• Overview of spinal tumors.

Severe, Continuous Abdominal and Lower Back Pain

While low back pain rarely radiates to the abdomen, abdominal disorders can often extend to the back and be felt as acute back pain. Acute lower back pain can be a symptom of an enlargement of the aorta (large artery) in the abdomen, called an abdominal aortic aneurysm. This condition becomes a serious medical emergency if the blood vessel ruptures or starts leaking blood.

The primary symptoms of an abdominal aortic aneurysm are severe, unremitting abdominal and lower back pain, and anyone with these symptoms needs to seek immediate medical attention as this is a life threatening condition.

For more information, see the following article:

• Abdominal aortic aneurysm.

About Spine-health.com

Again, please note that all of the above conditions are quite rare (especially compared to the more common causes of back pain) and most conditions that cause back pain do not require immediate medical care. That being said, we think it is always useful to know which specific symptoms are most dangerous and we hope that this newsletter has been a helpful discussion on this topic.

Best regards,
Peter F. Ullrich, Jr., M.D., Medical Director
Stephanie Burke, President

About the Spine-health.com Newsletter: Each issue of the Spine-health.com newsletter, SpineNews Update, is written by the founders of Spine-health.com - Peter F. Ullrich, Jr., M.D., Medical Director for Spine-health.com and Stephanie Burke, President of Spine-health.com. The content in the newsletters is not peer reviewed by Spine-health.com’s Medical Advisory Board. The articles to which the Spine-health.com newsletters link have been peer reviewed by members of the Medical Advisory Board.