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Emergency causes of low back pain


Many different problems can cause low back pain. Most of the times, the first treatment that your health care provider will recommend for low back pain are a short period of rest and medicines. You usually don't need medical tests at first.

Some low back pain may also be from spine problems that need to be treated right away. Your provider will ask you about red flag findings. These are things that suggest a more serious issue may be causing your pain. Red flag findings include:

  • You have pain that occurs after a serious accident or injury.
  • You have fever along with your pain.
  • You have muscle weakness or numbness in your leg that does not go away, or that gets worse.
  • Your pain is severe and is not relieved by pain medicines. Or your pain has gotten worse or has lasted longer than 1 month and has not gotten much better.
  • You are having problems controlling bowel movements or urination, or problems emptying your bladder or bowels.
  • You are losing weight without trying.
  • You are over 65.
  • You have had cancer or many of your family members have had cancer.

None of these things alone means you have any of the problems that are described below. But their presence means your provider may want to do further testing soon or even right away.

Emergency causes of low back pain that involve the spine are:

  • Infection of the spine. Infection can occur in the spinal bones (osteomyelitis), in the disk located between the bones (diskitis), or in the soft tissue around your spine (abscess).
  • Cancer or tumor in your spine. Most often this is a cancer that has spread to your spine from somewhere else in your body.
  • Fracture of the spinal bones.
  • Slipped disk that could cause long-term damage to the spinal nerves.

Problems that may cause pain in the lower back that do not involve the spine itself are:

  • An aortic aneurysm that is leaking. An aortic aneurysm is a bulging area in the wall of the aorta, the main artery in your chest and abdomen.
  • A kidney infection or kidney stones.
  • Other problems with your internal organs, such as the uterus, ovaries, prostate, gallbladder, pancreas, or bladder.
  • Cancer of your abdominal structures.
  • Problems related to pregnancy.
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Review Date: 4/23/2016

Reviewed By: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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