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Step 8: When is low back pain a serious sign?
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Tests will be ordered if your doctor has concerns that a serious problem or underlying medical condition is causing your back pain. Keep in mind that most of the time, low back pain gets better on its own with little intervention or only simple treatment measures.

Cauda Equina Syndrome

In the lowest part of the spinal column, there is a collection of nerve fibers, sometimes called "the tail" of the spinal cord. This collection of nerves is called the cauda equina, Latin for horse’s tail. If these fibers become trapped, you can lose control of bladder and bowel function. This is called cauda equina syndrome. Other symptoms of this condition are:

  • Dull back pain
  • Weakness or numbness in your buttocks, genital area, or thighs
  • Inability to control urination or bowel movements

This condition must be treated with immediate surgery to reduce the risk of permanent problems.

Other warning signals

When evaluating you for back pain, your doctor will be checking for signs of the following:

  • Infection (like meningitis, an abscess, or urinary tract infection)
  • Hernia
  • Cancer
  • Kidney stone or other kidney disorder
  • In men, a problem with the testicles or scrotum (like a twisted testicle)

If any of the following are present, it will raise greater concern that one of these problems may be causing your back pain:

  • Pain awakens you at night.
  • You have a fever along with your pain.
  • Pain gets worse when you lie down.
  • The pain is not related to your movement. In other words, no particular movement makes the pain better or worse. It is just bad all of the time.
  • You have been losing weight unintentionally around the time that your pain began.
  • You have a long history of steroid use (for example, for severe asthma).
  • You use intravenous drugs.
  • You have urinary tract symptoms along with the back pain like burning with urination or blood in your urine.
  • Your pain is very sharp.


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Review Date: 6/29/2011
Reviewed By: Andrew W. Piasecki, MD, Camden Bone and Joint, LLC, Orthopaedic Surgery/Sports Medicine, Camden, SC. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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