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Red Flag Symptoms
The vast majority of back problems improve on their own or with nonsurgical
treatment. There are a few warning signs, however, that may indicate
serious spinal problems. If you experience any of these symptoms, seek
medical attention immediately.
Loss of control of the bowel or bladder and retention of
urine may indicate damage to the spine's cauda equina nerves. The cauda
equina is a bundle of nerves in the low back where the spinal cord ends.
Damage to these nerves can be permanent if not treated immediately (within
a day or so). See a spine specialist, or go to an emergency room if necessary.
Weakness or numbness in a leg or arm, especially if it
is severe—and it is getting worse—also points to nerve damage.
This includes "foot drop," a condition where the muscles of
the leg and foot are too weak to raise the foot up as the individual
attempts to walk. Again, nerve damage associated with these symptoms
can be permanent if not treated immediately. This problem should be seen
within 24 hours by a spine specialist.
Numbness, pain or tingling that radiates into the arm or
leg is also a source for concern and should be seen within a few days
by a spine specialist.
High fever accompanied by back pain may indicate a possible
infection of the spine and should be treated within 24 hours.
Rules of Thumb on Symptoms
Here's an encouraging back
fact: 80 percent of the time, back and neck pain
is simply a result of strain or soft tissue injury. In many of
these simple cases of back or neck strain, your condition will
improve with specialized exercises, rest, and anti-inflammatory
medicine. Other times, you may need to see a doctor, perhaps
even as soon as possible. Briefly, here are some rules of thumb
to keep in mind about your back or neck problems:
- Trauma - If you fall down,
are in a car accident, or do anything abrupt that may have fractured
your back, go to a spine specialty clinic within 24 hours.
- Radicular pain - Anytime
you have back or neck pain that radiates down into your leg or arm,
you probably need to be evaluated by a spine specialist within two
to three days, especially if it is getting worse.
- Persistent pain - If pain
limited to the low back or neck area does not begin to subside after
three days with anti-inflammatories and rest, then you probably need
to be evaluated by a spine specialist. For example, if you first noticed
back or neck pain on Monday, and it's now Thursday, and it's not getting
better, it's time to see a spine specialist to find out what is causing
- Anytime you experience loss of
control of your bowel or bladder, that is an EMERGENCY signal
that you need to see a spine specialist THE SAME DAY. If you wait
too long, you could suffer permanent paralysis of the nerves that
control these functions.
- Foot drop - If you notice
that your toe is dragging as you walk, this is a DANGER SIGNAL for
serious neurological problems. Again, if you delay, you could experience
permanent damage. This problem should be seen within 24 hours by a
- Weakness, numbness or pain that
extends below a knee or elbow is a serious symptom. Go to
a spine center within two days.
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