There are a million and one causes of low back pain, some of them sinister, others merely distressing. But some changes or associated symptoms with low back pain will be a cause of worry for both doctor and patient. While these signs do not automatically mean that something terrible is going on, they could serve as pointers to aid in picking up possible ongoing disease processes.
- Severe Pain: The more severe the back pain, the greater the likelihood that it is caused by an underlying disease process. Low back pain from cancers has been reported to be severe.
- Unexplained Weight Loss : Unexplained and unintentional weight loss could suggest the presence of an ongoing disease process, more commonly cancer. If an individual experiences low back weight and weight loss also, he/she will need to be evaluated for conditions, such as cancer and tuberculosis of the spine.
- Age over 50 years or under 18 years old: Older people and adolescents who complain of back pain are more likely to have some disease conditions rather than just mere bone/joint pains. This is because back pain in these age groups is more suggestive of some serious conditions. In older people, it could suggest disc slips, spinal fractures, or spinal arthritis. In adolescents, it could suggest an infectious cause.
- Failure to improve with therapy: When the use of pain medications and lifestyle modifications fail to improve low back pain, it is then deemed as a “red flag” for that pain. It increases the likelihood that the disease process is not just back pain due to innocuous causes.
- Pain persists for more than 4 to 6 weeks: Usually back pain comes and goes from time to time. But the presence of back pain continuously for a protracted period, say 4 weeks, could be a reason for you to see a doctor as soon as possible.
- Night pain or pain at rest: Pain at rest is evidence of a non-mechanical cause of back pain as it points to the fact that movement is not needed to cause pain. Pain at night has also been shown to be a pointer to more severe diseases, including tuberculosis of the spine and cancer metastasis.
- Persistent fever (Temperature over 37.5 o c): The presence of fever is highly suggestive of back pain due to infective causes. In endemic areas, tuberculosis is the usual culprit but there are other infections that could be the cause of fever.
- History of Intravenous Drug Abuse: A history of abuse of intravenous drugs (drugs that are injected directly into the blood stream) and associated back pain raises the need to see a doctor promptly as this could be a pointer to infections affecting the spine.
- Lumbar Spine surgery within the last year: If you have had lumbar spine surgery in the last year, the presence of low back pain can be a pointer to a complication from the surgery and you should see a doctor as soon as possible.
- Wound in spine region: The presence of a wound over the lower back is a pointer to a likely infection of the spine and it warrants immediate presentation at a hospital. The wound means that the barrier between the spine and the external environment has been compromised to some degree, posing a great risk of spinal infections that could also spread to the brain.
- Immunocompromised states: Individuals who have low immunity will have a high index of suspicion for sinister causes if they complain of low back pain. Individuals with cancer, uncontrolled Diabetes Mellitus, HIV, Organ transplants, tuberculosis, malnutrition, being treated with drugs that reduce immunity such as steroids, anticancer drugs, etc. are likely to have low back pain from disease processes, such as Tuberculosis and cancer
- Saddle Anaesthesia: This is described as the absence of feeling in the region around the anus. It is usually detected by the doctor but can be noticed by conscientious individuals. This is usually a pointer to spinal cord compression and will need immediate intervention to prevent further damage.
These are just few of a myriad of signs that are classified as danger signs of low back pain. Presence of any of these will warrant prompt presentation at a hospital to see a doctor.
