Published on: 8/15/2024
Consider going to the emergency room (ER) for back pain if it is extremely intense, accompanied by difficultly walking or standing, or a loss of bowel or bladder control.
Back pain can be caused by many things that span benign to life-threatening. Distinguishing between them can be challenging even for the seasoned clinician. Generally, extremely severe debilitating back pain, or pain accompanied by difficulty walking/standing, fevers/chills or loss of bowel/bladder control should prompt a visit to the emergency room. You may also consider if you have risk factors for more severe causes such as age (<18 or >50), immunocompromise, or underlying conditions such as cardiovascular, kidney, liver or bone disease.
(References)
Edwards J, Hayden J, Asbridge M, Gregoire B, Magee K. Prevalence of low back pain in emergency settings: a systematic review and metaanalysis. BMC Musculoskelet Disord. 2017 Apr 4;18(1):143. doi: 10.1186/s1289101715117. PMID: 28376873; PMCID: PMC5379602.
Knezevic NN, Candido KD, Vlaeyen JWS, Van Zundert J, Cohen SP. Low back pain. Lancet. 2021 Jul 3;398(10294):7892. doi: 10.1016/S01406736(21)007339. Epub 2021 Jun 8. PMID: 34115979.
Urits I, Burshtein A, Sharma M, Testa L, Gold PA, Orhurhu V, Viswanath O, Jones MR, Sidransky MA, Spektor B, Kaye AD. Low Back Pain, a Comprehensive Review: Pathophysiology, Diagnosis, and Treatment. Curr Pain Headache Rep. 2019 Mar 11;23(3):23. doi: 10.1007/s1191601907571. PMID: 30854609.
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