Back pain is unfortunately a common issue, plaguing an estimated 31 million US adults, affecting roughly 80 percent of people at some point in their lifetime. Yet in most cases, it’s not debilitating. As we age, our bones and tendons become progressively weaker, and the wear-and-tear of existence leads to aches and pains that, in most cases, are inevitable.
A good diet and regular exercise prolong quality of life and can often help keep the pain at manageable and even unnoticeable levels, but it catches up to us eventually.
Some pain, however, is more than just a nuisance. It can be disabling or accompanied by symptoms that are far out of the ordinary. It’s critical to distinguish from regular lower back pain and the kind that may require immediate medical attention, hinting not only at a case of age-related osteoarthritis, but something potentially far more sinister. The following five symptoms are examples of symptoms that may coexist with back pain, hinting at a deeper issue that requires medical attention.
Bladder and Bowel Issues
If you’re struggling with slight lower back pain, chances are that a good stretch and a quick rest will help you feel better. But if you’re experiencing a secondary symptom such as incontinence, you should immediately arrange for a trip to the emergency room.
Loss of bladder and/or bowel control coupled with back pain is a potential sign of a herniated disc, transverse myelitis, and cauda equina syndrome (a collection of symptoms caused by compressing a bundle of nerves near the lower portion of the spine called the cauda equina). A ruptured or herniated disc can put significant pressure on other nerves in the area, leading to radiating pain in other parts of the body, numbness, and even temporary paralysis. Getting your spine checked is important.
Not all cases of incontinence are caused by nerve compression. Some other causes include pregnancy or imminent childbirth in mothers, prostate cancer in men, and frequent UTIs. However, it’s important to be better safe than sorry. Visiting the ER if your back pain is coupled with bladder or bowel issues could save you from struggling with even worse symptoms down the line.
Chills and Fevers
Fevers occur when the brain is told that a threat has been detected. The brain – particularly, the hypothalamus – turns up the heat and retains any heat generated, causing our body temperature to spike considerably while our immune system goes into overdrive to identify and eliminate the threat. This is caused by the release of a certain chemical from affected tissues in the body, prompting the sympathetic nervous system to heat up.
Common causes for a fever include an infection of any kind. In most cases, fevers are an indication that the body is working hard to address a threat. But fevers can be dangerous. While fevers help fight infections, the human body can only tolerate a short range of body temperatures. Too low, and we die of hypothermia. Too high, and we die of hyperthermia. Our ability to exist and thrive in various climates is a testament not to the resilience of our organs, but our ability to regulate body temperature through the skin – but if the source of all the heat is within the body, the skin can’t do quite as much.
While fevers are already a reason to consider seeing the doctor – especially once temperatures spike – fevers and chills coupled with serious back pain may hint at some particularly troubling conditions. Namely, epidural abscesses, Lyme disease, osteomyelitis, and other forms of infection pressing on the spine and surrounding nerves. If not addressed, the back pain could become worse, and in cases such as Lyme disease or abscesses surrounding the spine, immediate medical attention is necessary.
Balance issues coupled with lower back pain may be a sign of spinal stenosis, or nerve compression of the nerves either around the spine, or the spinal cord itself. While stenosis can occur on its own as a result of osteoarthritis, spinal compression can also be related to a previous injury or the result of repeated strenuous activity.
Some forms of nerve compression do go away on their own, but spinal stenosis is a progressive condition – meaning over time, it becomes progressively worse. This progress can be halted with treatment and management of the condition, but it cannot be stopped permanently.
If you report balance issues to your doctor, they will ask you a series of questions and potentially prepare an imaging test to confirm the cause of your condition.
The nerves that run along the spine from neck to bottom are responsible for a large majority of our movement and physical constitution, including our ability to walk, stand, and hold objects. Which makes any numbness or pain in the legs a cause for concern, when coupled with back pain.
Pain in the leg – from the buttock to the toes of one leg – is a sign of sciatica, a condition caused by compression of the sciatic nerve, typically through a herniated/ruptured disc.
Pain around the upper back or neck is commonly associated with a simple muscle strain or sleeping the wrong way, but if coupled with other neurological symptoms – particularly tingling in the arms and fingers, difficulty with dexterous activities like undoing buttons, or other forms of weakness in the hands – then the spinal cord in the upper portion of the back may be affected by compression or disc degeneration. A swift response can prevent the problem from getting worse.
Why a Rapid Response to Lower Back Pain Matters
Lower back pain can be minor, and is often acute, flaring up under specific circumstances or after a particularly grueling bout of physical activity. These pains often go away on their own, and can be managed through rest, heat and cold compress, anti-inflammatory foods, and over-the-counter pain medication.
Yet many of the pains described above are attributed to spinal conditions that, if not addressed adequately within an appropriate window of time, may worsen into a chronic or progressive condition. From spinal stenosis to sciatica or an epidural abscess, swift and decisive action can often save the day and save you countless hours spent struggling with excruciating pain.
Interventions differ from condition to condition, yet lifestyle changes are often a part of making an effective recovery, with and without prior surgery. Doctors will often work with patients to assign them to physiotherapists with experiences in spinal conditions, and other suggested changes may include pursuing a safer line of work, avoiding certain activities, and strenuously monitoring for other potential symptoms.