When to See a Doctor for Types of Severe Back Pain

Back pain slows down millions of Americans each year, with symptoms ranging from nuisance soreness to back pain so severe and debilitating that a visit to the emergency room becomes the first step on a path leading to a spinal surgeon’s care. According to the American Association of Neurological Surgeons, back pain is the second most common reason that adults see a doctor.

Back pain can occur anywhere on the back, from the neck (cervical area) to the middle of your back (thoracic area) to the lower back (lumbar area) with the lower back often being the most common location of severe and lifestyle-limiting pain, since the lower back bears most of your weight. That weight can compress the cartilage cushion between your vertebrae. And, over time, you might experience a degeneration of that cushioning cartilage, causing your discs to compress or slide out of place.

Walking, bending, lifting, twisting, even sitting and standing can then become excruciating. Back pain flares up and then goes away on its own after a few days for some people. But for others, sharp pains and limited motion becomes a bigger, more longer-lasting problem requiring medical care.

Here are some of the more severe back pain conditions:

  • Disc degeneration: Discs in the spine can deteriorate with age, and the deterioration of discs can lead to inflammation and irritation in the spine, which can cause great pain.
  • Sciatica: While many people associate the term ‘sciatica’ with pain in the buttocks area, sciatica can be a painful condition in the back. Sciatica is caused when the sciatic nerve (a bundle of lumbar nerves) becomes irritated by a herniated disc. This condition is known as spinal stenosis. The sciatic nerve can also be irritated by an abnormality in a vertebra that puts pressure on it. Sciatic pain may be felt in the lower back or buttocks, and may also be felt in the calf and the foot. Sciatica pain can be mild with tingling, or it can become severe, growing worse at night. You might experience worse sciatica pain when you have long stretches of standing or sitting.
  • Lumbar spinal stenosis: When spinal degeneration occurs, the canal through which spinal nerves travel can narrow. As part of the aging process, discs can dry out and shrink. When these two conditions occur, you might experience painful pressure on a spinal nerve. This can happen with a minor injury, as a symptom of osteoarthritis of the spine, or simply as a symptom of aging. The resulting back pain can be severe.
  • Osteoarthritis: Arthritis anywhere in the body can be painful, but when osteoarthritis occurs in the back, you may experience pain and muscle spasms. Osteoarthritis can affect the cartilage in the discs, the vertebrae, or both anywhere along the spine, pinching the nerves and causing pain.
  • Herniated disc: Also called a ‘slipped disc,’ this condition occurs when a damaged or bulging disc pinches or irritates a nerve root.

Emergency Back Pain Symptoms Requiring Immediate Care

Certain symptoms associated with back pain are considered emergencies and require immediate care to prevent severe complications. These include:

  • Sudden back pain that makes it difficult to stand or walk
  • Sudden neurological symptoms, including back pain that radiates to the extremities, numbness, or tingling
  • Sudden numbness in the legs or pelvis
  • Changes in bowel or bladder concern
  • Fever
  • Severe back pain that develops after an injury
  • Unexplained weight loss
  • Loss of consciousness

If you experience any of these symptoms, seek immediate medical care. They may be signs of serious conditions like cauda equina syndrome or spinal infections. 

Neurological Symptoms That Shouldn’t Be Ignored

Neurological symptoms arise from problems with nerve tissue, whether from the nerve roots, spinal cord, or brain. If you experience these symptoms with back pain, it’s a sign that you’re dealing with nerve compression in the back, often from symptoms like a herniated disc, spinal stenosis, scoliosis, or even vertebral fractures. 

You should never ignore neurological symptoms, as nerve compression requires prompt care to prevent worsening discomfort. These include radiating back pain, weakness, numbness, and tingling.  

Differentiating Between Common and Serious Back Pain

If you’re unsure, the best way to differentiate between common and serious back pain is to visit a medical professional for an evaluation. But if you’re looking to better understand your condition at home, keep these points in mind:

  • Common Back Pain
    • Common back pain, like pain from sprains and strains, often has a clear cause. You may lift a heavy box, for example, and feel an immediate twinge. 
    • Common back pain also tends to feel like stiffness or a dull ache, as opposed to sharp or burning pain. 
    • Common back pain usually starts to improve within a few days or weeks of at-home care, like rest, ice, and heat. 
  • Serious Back Pain
    • With serious back pain, it’s often more difficult to pinpoint the exact cause. 
    • Serious back pain feels more severe and is more likely to interfere with your daily activities. It may also radiate to the extremities and occur with other neurological symptoms. 
    • Serious back pain may occur after a traumatic accident, like a car accident, a fall, or another significant injury.  
    • Serious back pain is usually recurring and persistent, even with rest and other home remedies. 

When Conservative Treatment Isn’t Enough

Sometimes, conservative treatment like home remedies, physical therapy, and painkillers isn’t enough. In these cases, a doctor can help you determine the best path forward. 

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When severe back pain occurs, your physician will assess you for various spinal conditions, and you will likely start on a back pain reduction plan that aims to reduce your discomfort, restore your mobility, and manage your back pain flare-ups. Perhaps you and your doctor will decide that spinal surgery is the best solution to remedy the internal causes of your severe back pain, returning you to a better quality of life.

The TOPS™ System is one such solution. The TOPS™ (Total Posterior Spine) System provides an alternative to spinal fusion for patients undergoing spinal decompression back surgery. Unlike spinal fusion, TOPS preserves the full range of the spine’s natural motion and has been shown to provide better outcomes than fusion in clinical studies performed around the world.

Questions Your Doctor Will Ask About Your Back Pain

When you visit your doctor to ask about back pain, they’ll ask various questions to gain more information that can help them provide a diagnosis. Examples include:

  • Where is your pain located? Does it occur on one side of the body or both?
  • What does your pain feel like? Is it dull, sharp, aching, throbbing, burning, or radiating?
  • When did your pain begin? Did it start suddenly or develop progressively?
  • Can you rank your pain’s severity on a scale of one to 10?
  • Are you experiencing any other symptoms?

Preparing for Your Back Pain Appointment

Preparing for your back pain appointment can help ensure all of your questions get answered and that your doctor receives the information they need to make an accurate diagnosis. Get ready by:

  • Collecting any relevant medical records, like records of past injuries, spinal conditions, surgeries, and other treatments
  • Keeping a pain journal to record your symptoms and provide accurate timelines
  • Making a list of your questions and concerns (in the moment, it can be difficult to remember all of the points you want to address – a written or typed-out list can help)