What is a Back Pain Emergency?
Back pain emergencies are rare… but they do happen. And, it can be tricky to distinguish the truly “insidious” from the “benign.” That’s because back pain—usually a guiding light in these matters—is an unreliable indicator of critical status when it comes to back pain emergencies. In fact, sometimes the least serious conditions, like a torn muscle, are the most excruciating.
So, how can you know when to rush off to the emergency room or just chalk it up to your garden-variety, run-of-the-mill back pain? The only (and best) answer is to consult your doctor ASAP. Nevertheless, we’ll review the 5 major types of back pain emergencies, as well as some obvious signs that it’s time to make that ER visit.
The 5 Major Types of Back Pain Emergencies
Keep in mind that back pain emergencies can come on very suddenly… or they can take several weeks to fully emerge. For this reason, we’ll be grouping these events into rapid-onset vs. gradual-onset emergencies.
Rapid-Onset Back Pain Emergencies
- Spinal Fractures: Spinal fractures can occur for many different reasons, the most obvious of which involve injury. However, a solid chunk of spinal fractures are also pathologic in nature. This means that they indicate the presence of an underlying disease, like osteoporosis or a spinal tumor. Regardless of their cause, spinal fractures can make the spine quite unstable. In the long run, this can lead to more serious issues, like spinal deformities. To prevent future problems, like kyphosis, always treat spinal fractures as a back pain emergency.
- Abdominal Aortic Aneurysms (AAA): Your aorta is the largest artery in your body. It extends from your heart, along the front side of your spine, and through your abdomen, where it branches into the iliac arteries. Specifically, your abdominal aorta supplies blood to most of the major organ systems in your body. If this segment of the vessel develops a weak spot, then the aorta may balloon outward, threatening to rupture. This blood-filled bulge, known as an aneurysm, causes symptoms of severe abdominal and back pain and can be deadly if it bursts.
- Cauda Equina Syndrome (CES): A delicate bundle of nerve fibers in your lumbar and sacral spine, your cauda equina resembles a horse’s tail. Consistent with its location, your cauda equina supplies sensation and movement to the muscles of your legs, bladder, and bowels. As such, pinching of this nerve group, known as CES, can cause symptoms such as incontinence, paralysis, or numbness in the groin (aka, saddle anesthesia). Without proper treatment, the symptoms of CES, like paralysis, can become permanent.
Gradual-Onset Back Pain Emergencies
- Spinal Infections: Spinal infections can attack many different parts of the spine, including the discs, vertebrae, meninges, and spinal canal. These bacterial, fungal, or viral infections usually enter the spine by means of the bloodstream. This can occur after a patient undergoes a surgical procedure or as a complication of certain illnesses (e.g. autoimmune diseases, urinary tract infections, etc.). Unlike the common cold, the symptoms of a spinal infection can take up to 6 weeks to manifest. However, spinal infections can cause serious problems, like spinal fractures or decay to occur.
- Spinal Tumors: Spinal tumors are abnormal masses of cells that grow on the vertebrae, meninges, nerves, or spinal cord. Although rare, spinal tumors often spread to the spine from cancers that are located elsewhere in the body, such as breast, lung, or prostate cancer. If you have a spinal tumor, in fact, your first indication of a problem may be a spinal fracture or Cauda Equina Syndrome. Spinal tumors require immediate treatment to diagnose and to prevent from spreading to adjacent organ systems.
Key Symptoms of Back Pain Emergencies
If you suspect that you could have a spinal fracture, aortic abdominal aneurysm, or cauda equina syndrome, then seek medical attention right away. The symptoms of these conditions tend to be more obvious than with gradual-onset disorders and typically involve more severe pain. Keep a watchful eye out for the following symptoms or precipitating events:
Spinal Fracture Symptoms:
- You sustained a sudden blow to the spine and are experiencing severe back or neck pain
- You have (or suspect that you might have osteoporosis) and are experiencing severe back or neck pain out of proportion to the causative event (e.g. coughing, twisting your torso the wrong way, etc.)
- Lying flat on your back alleviates your pain but standing upright makes your pain more intense
- Your back pain is accompanied by a loss of spinal mobility, height, or signs of physical deformity (such as kyphosis or “hunchback”)
Abdominal Aortic Aneurysm (AAA) Symptoms:
- Your back pain occurs with severe and unremitting abdominal pain
- You feel a throbbing sensation near your belly button
Cauda Equina Syndrome (CES) Symptoms:
- Numbness or a lack of sensation in your saddle region (the groin, buttocks, and rectum)
- Incontinence (or loss of bowel and bladder control)
- You develop numbness in your legs or hamstring muscles that interferes with your ability to walk
The symptoms of gradual-onset disorders, like spinal tumors and infections, are more difficult to define. However, you should consult a doctor if your back pain coincides with the following symptoms:
- Fever, chills, or night sweats
- A loss of appetite or unexplained weight loss
- Nausea or vomiting
- Pain that is worse at night or that prevents you from sleeping
Worried that You Have the Symptoms of a Back Pain Emergency?
Then, don’t delay to make a visit to the emergency room. Even if the cause of your pain turns out to be “benign,” knowing the source can give you the peace of mind to initiate your recovery process — free of dread. In the days following your diagnosis, make sure to follow up with a board-certified orthopedic surgeon. A skilled orthopedist can help you devise a long-term plan for dealing with episodes of both acute and chronic back pain. For back pain advice that you can trust, contact our team of Top Doctors at the Advanced Spine Center today!