Non-specific back pain is a serious public health problem worldwide. Most people will experience back pain throughout their lives. The first episode usually occurs between 20 and 40 years. The pain can be of moderate or severe magnitude until invalidating.
Back pain can last for weeks, months or even years, so it can be a worrying thing. However, it is rarely dangerous. Generally, the cause of back pain is benign and, with proper treatment, the patient’s prognosis is favourable.
Nevertheless, in a small percentage of cases (1% – 2%), back pain can be a symptom of a more serious underlying pathology that is dangerous. For instance: spinal cord tumours, vertebral fractures, cauda equina syndrome or infections, among other causes.
Warning signs: red flags
The presence of signals that can alert the presence of these serious situations is something that must be evaluated before any therapeutic intervention. For this reason, the detection of these signals (called red flags) during the analysis of the medical history and the physical examination plays a key role in the initial evaluation.
Because the presence of red flags can help to detect a greater risk of suffering these serious alterations. We are going to tell you the main suspicions that our doctors look for and some of the most recognized symptoms that put us on alert:
The following symptoms suggest this syndrome: Urinary retention (inability to completely or partially empty the bladder), urinary or stool incontinence, or that we have anaesthetized the area around the anus and between the anus and the genitals. These symptoms suggest an injury to the sacral roots, which in itself is a serious consequence regardless of the cause. The cause can be a huge herniated disc (most commonly), a tumour, bleeding or others.
Injury in the lumbar nerve roots
The appearance of weakness in different muscle groups of the lower limbs is an alarm sign for this case.
If you have had cancer recently or are going through one at the time of the consultation. Here we can also include people at risk of cancer because of their personal history or who is suspected by symptoms or risk factors. One common symptom is unexplainable weight loss.
Infections are another cause that concerns doctors. There are factors that suggest a high risk of spinal infection, either because of symptoms or because of your personal and medical history. For instance, an immunocompromised person (either due to illness or medication). Also, someone who has had a fever for a long time or has an infection that may have spread. Other factors, such as a patient who is on hemodialysis or addiction to injected drugs can alert us to a possible infection.
The possibility of having a fracture without significant trauma is a reality in some patients. A person who has taken corticosteroids for a long time or who have had osteoporosis for a long time, for example, warns us that the pain may be due to a fracture.
Sometimes the problem is not in the back and a life-threatening situation such as abdominal aortic aneurysm can occur. We suspect this in an elderly patient with pain that does not disappear with rest, in which a posture without pain is not found and in which we discover a pulsatile mass in the abdomen.
At the London Spine Unit, Harley Street Hospital, we have some of the best specialists to diagnose and treat your back pain. Book a consultation to get a doctor´s checkup.