10 Common Back Problems – When to Worry and When to See a Doctor
Herniated (‘slipped’) disc – a common cause of back pain
Here are 10 common back problems, including their definitions, symptoms, and guidance on when to worry and when to see a doctor.
1. Herniated (Slipped’) Disc
- What it is: A condition where the soft inner gel of the disc leaks out through a tear in the outer layer, irritating nearby nerves or the spinal cord (see picture above).
- It occurs when the (rubbery) disc between two vertebrae ‘comes out’. They can rupture as well.
- Depending on the ‘level’ they can cause neck, thoracic (mid-back) or lower back pian; and/or numbness, and tingling in the arms, buttocks, back and legs. The commonest levels are L4/5 and L5/S1.
- Pain can be severe, but 90% people are pain-free at 6 weeks. A few get pain for many months, occasionally life-long.
- Symptoms: Pain, numbness, tingling, or weakness in the back, legs, or arms, depending on the location of the herniated disc.
- When to worry: If pain radiates down your leg or arm, or if you experience numbness or weakness.
- When to see a doctor: If symptoms persist for more than a few weeks, or if you experience sudden severe pain or loss of bladder/bowel control.
2. Scoliosis
- What it is: An abnormal sideways curvature of the spine, leading to pain and/or breathing problems.
- Symptoms: Uneven shoulders, waist, or hips; leaning to one side; back pain.
- When to worry: If you notice unevenness in posture or clothes don’t fit properly due to asymmetry.
- When to see a doctor: If you suspect scoliosis in a child or adolescent; get a professional evaluation.
3. Spinal Stenosis
- What it is: Narrowing of the spinal canal, which can put pressure on the spinal cord and nerves.
- Symptoms: Pain, numbness, tingling, or weakness in the back, legs, or arms, especially with standing or walking.
- When to worry: If symptoms worsen with activity or if you experience significant pain or weakness.
- When to see a doctor: If symptoms persist or interfere with daily activities; seek medical attention if severe.
4. Spondylolisthesis
- What it is: A condition where one vertebra slips forward over the one below it.
- Symptoms: Lower back pain, stiffness, and nerve compression symptoms like numbness or weakness in the
- legs.
- When to worry: If you experience persistent back pain or nerve symptoms.
- When to see a doctor: If pain persists or if you notice significant worsening of symptoms.
5. Muscle Strain
- What it is: Overstretching or tearing of muscles in the back; usually caused by lifting something heavy or sudden movement, leading to pain and stiffness in the back.
- Symptoms: Pain, stiffness, and muscle spasms.
- When to worry: If pain is severe or persists despite rest and self-care.
- When to see a doctor: If pain doesn’t improve with rest or if you suspect a more serious injury.
6. Sciatica
- What it is: Pain that radiates along the path of the sciatic nerve, which runs from the lower back through the hips and down each leg.
- Symptoms: Sharp, shooting pain, numbness, tingling, or weakness in the lower back, hips, and legs.
- When to worry: If pain is severe, persistent, or accompanied by numbness or weakness.
- When to see a doctor: If symptoms persist or worsen; seek medical attention if severe or if you experience loss of bladder/bowel control.
7. Osteoporosis-Related Vertebral Fracture
- What it is: Brittle bones that can lead to vertebral fractures and back pain. This is a common cause in the elderly
- Symptoms: Sudden severe back pain, loss of height, or stooped posture.
- When to worry: If you experience sudden severe back pain or notice changes in posture.
- When to see a doctor: If you suspect a fracture or have osteoporosis risk factors; seek immediate medical attention.
8. Kidney Stone or Infection (Pyelonephritis)
- What they are: Kidney stones are small, hard mineral deposits that form inside the kidneys when there is an imbalance of water, salts, and other substances in the urine; whilst a kidney infection (or pyelonephritis) is usually caused by a bacterium such as E Coli. It will make you more unwell than a simple bladder infection (cystitis) though the organisms that cause it are similar.
- Symptoms: Severe pain in the back or side, nausea, vomiting, frequent or painful urination, and blood in the urine.
- When to worry: You should worry if you experience severe pain that doesn’t go away, blood in the urine, fever, chills, or difficulty urinating.
- When to see a doctor: See a doctor immediately if you have symptoms of a kidney stone (or infection), especially if you have severe pain, fever, or vomiting, or if you’re unable to pass a stone after a few days.
Note 1. Back pain is rarely due to kidney stones, infection or other kidney diseases.
Note 2. Site of kidney disease. If kidney stone/infection does cause back pain, it is on the side of the mid-upper back (see picture above) and can be around the front of the tummy too (same level). Pain that is low and central is usually due to spinal (not kidney) problems.
9. Spinal Tumour or Infection /Abscess
- What are they: A spinal tumour is an abnormal growth of cells in or around the spinal cord/whilst a spinal infection or abscess is a collection of pus or infected tissue that can put pressure on the spinal cord or nerves.
- Symptoms: Symptoms can include back pain that worsens over time, numbness, weakness, or paralysis in the arms or legs, loss of bladder or bowel control, and fever or chills in the case of an infection.
- When to worry: You should worry if you experience sudden or severe neurological symptoms such as numbness, weakness, or paralysis, loss of bladder or bowel control, or severe back pain that doesn’t improve with rest.
- When to see a doctor: See a doctor immediately if you have severe back pain, new or worsening neurological symptoms, fever, or recent trauma or infection; as prompt medical attention can help prevent long-term damage.
Note. They are rare but serious conditions that require immediate medical attention.
10. Spinal Osteoarthritis
- What it is: Wear and tear arthritis that affects the joints and discs in the spine; a cause of back pain in older people
- Symptoms: Pain, stiffness, and reduced flexibility in the spine.
- When to worry: If back pain persists or interferes with daily activities.
- When to see a doctor: If pain lasts more than a few weeks or if you notice significant worsening of symptoms.
Another back problem
Ankylosing Spondylitis
- What ot is: A type of arthritis that causes inflammation in the spine and other joints, potentially leading to fusion of vertebrae.
- Symptoms: Chronic back pain and stiffness, especially in the morning or after rest; fatigue.
- When to worry: If you experience persistent back pain and stiffness, especially if it’s worse in the morning.
- When to see a doctor: If symptoms persist or interfere with daily activities; get a professional evaluation.
Red flags: When to See a Doctor Now
- Severe Pain: intense pain that doesn’t improve with rest or medication
- Numbness or Tingling: persistent numbness or tingling in the legs or feet
- Weakness: weakness in the legs or feet
- Loss of Bladder or Bowel Control: sudden loss of control over urination or bowel movements. This is a very serious sign, and may been you need an operation very soon. See a doctor today. Go to A&E
- Fever: fever accompanying back pain
- Unexplained Weight Loss: sudden weight loss without changes in diet or lifestyle
- Recent Trauma: back pain after a fall, accident, or sports injury
- Night Pain: back pain that wakes you up at night or is worse when lying down
- Pain that Radiates: pain that radiates to other areas, such as the buttocks, legs or hips.
Note. If you have any of these, you should see a doctor very soon.
If you’re experiencing any of these symptoms, it’s essential to consult with a doctor for proper diagnosis and treatment. They can help determine the underlying cause of your back pain and recommend the best course of action.
