Serious Back Pain
ESTIMATED READING TIME: 3 MINUTES
Most back pain resolves over time through an active approach and sensible management. ‘Serious’ back pain is rare but is present in a small percentage of cases. It is important to know what symptoms to be aware of, what to do if you get them and how quickly you should act on them.
Certain symptoms require an urgent, same day opinion with your local emergency department. Seek help immediately if you have back and leg pain and any of the following symptoms:
- Loss of feeling or pins and needles in your inner thighs or genitals.
- Numbness in or around your back passage.
- Altered feeling when using toilet paper to wipe yourself.
- Increased difficulty trying to urinate.
- Leaking or difficulty trying to stop or control your flow of urine.
- Not knowing when your bladder or bowel are full or empty.
- Loss of sensation when passing urine or stool.
- A change in sexual function - such as a change in the ability to achieve an erection or ejaculate.
- Loss of feeling in your genital region during sexual intercourse.
- Difficulty walking and/or heaviness in your legs.
Back-related causes of these symptoms are rare, but it is vitally important you act immediately if you develop the symptoms above, as delaying a medical assessment could seriously impact your long-term health.
Click the button below to download a letter you can take with you to A&E to help you explain why you are attending:
If there is a history of recent injury to the spine - such as a fall from a height, road traffic accident or a direct blow to the back - you need to be aware of the symptoms listed on this page and seek medical advice if any of these symptoms develop.
Certain symptoms require an urgent opinion but not necessarily the same day. Seek help quickly from a healthcare professional, such as your GP, if you have any of the following symptoms:
- Back pain that is getting worse, is severe and is different to your "normal pain".
- Pain that spreads like a band around your body, stomach area or trunk, or that spreads into your lower back, buttocks, or legs.
- Odd feelings in your legs with the feeling of unsteadiness.
- Altered sensation/pins and needles in both legs/feet.
- Difficulty walking and heaviness in your legs.
- Back pain that stops you sleeping at night or gets worse when lying down.
- Fever or chills that came on around the same time as your back pain.
- Night sweats.
- Back pain accompanied by sudden unexplained weight loss or a general feeling of being unwell.
- Structural deformity – a change in the appearance of your back/spine.
Please note: If you have been diagnosed with cancer or have a history of cancer in the past, it is essential that you seek medical advice for the above symptoms without delay. Earlier investigations will lead to a better treatment outcome.
MacMillan Cancer Information Spine
Acknowledgements: this content was adapted from the Musculoskeletal Association of Chartered Physiotherapists (MACP) educational video which is included on this page.
Content last reviewed: 23/12/2022