When to See a Doctor for Neck or Back Pain

Most of the time, back or neck pain goes away on its own. Just the same, some or all of your symptoms may point to the need for medical attention. And although the possibility is rare, you may even need to go to the emergency room.

When you're in doubt about the severity or meaning of your symptoms, a call to your primary care provider is in order. Here are eight signs that indicate you should definitely see a doctor for your neck or back pain.

Person in bed holding neck and back
Tetra Images Collection /Brand X Pictures / Getty Images 

Pain That Keeps You Up At Night

Back pain that keeps you up at night, or gets worse when you rest, is generally not life-threatening. That said, it's best to get it checked, especially when accompanied by fever. 

Back or neck pain with fever may be a sign of an infection such as meningitis. Infections can get serious, fast, so don't delay that call to your doctor — prompt diagnosis and treatment may save your life.

You Have Had Cancer

A history of cancer combined with first time back pain may be a warning sign for colon, rectum, or ovary cancer. Growing cancer might put pressure on organs, nerves and/or blood vessels; the pressure, in turn, may cause back pain. What's worse, the pain may not occur until the tumor is fairly large.

Generally, once there's pain, cancer has already begun to spread. Because of this, it's best to seek medical attention as early as you can.

You Are Over 50

As we age, the potential for back pain increases. In people who menstruate, the increase may coincide with the advent of perimenopause, according to a 2015 study published in the journal Menopause Review.

And because aging is often accompanied by a slowdown and a more sedentary lifestyle, it may also contribute to obesity, which is associated with an increased risk for back pain. The Menopause Review study mentioned above found that obesity, defined as a body mass index (BMI) over 30, increases the prevalence of pain in females.

If you're over 50 and have back pain, particularly if you're also female, your doctor may be able to work with you on a pain control plan, using a combination of physical therapy, weight management, and other relevant treatments.

Incontinence or Leg Weakness

If controlling your bladder or bowel has rapidly become a challenge, and/or your legs have been growing progressively weaker, you should seek immediate medical care.

Bowel and bladder incontinence, progressive weakness, and loss of sensation in the seat area are symptoms of cauda equina syndrome, which is a very serious condition. Cauda equina syndrome generally requires emergency back surgery.

You Had a Fall, Accident or Trauma

If you've recently been injured via a fall, blow or accident, the back or neck pain that follows should be checked by a doctor as soon as possible. Even if you were able to walk away intact, any new spine pain may be related to the impact.

If you have osteoporosis and have recently fallen or been in an accident, there is an increased likelihood of a spine injury.

Pain Radiates Down One Leg or Arm

Pain, weakness, numbness and/or electrical sensations that go down one leg is often called sciatica. Although sciatica symptoms may result from a tight piriformis muscle (leading to piriformis syndrome) these symptoms are more often due to pressure on a spinal nerve root. Symptoms that result from pressure on a spinal nerve root are called radiculopathy.

To diagnose your sciatica, your doctor will likely try to elicit your symptoms by testing your dermatomes. Dermatomes are areas of skin that are served by spinal nerve roots. 

This testing may help identify the exact spinal nerve root or roots that are irritated. In turn, this may help make your treatment choice as accurate as possible. Radiculopathy is often caused by a herniated disc, but not always. It may also be due to other things, for example, bone spurs that press on spinal nerve roots.

Bending or Flexing Worsens Symptoms

Leg pain that gets worse when you bend over or lift your knees towards your chest is another possible indication of a disc problem. Disc problems may include bulging discs, herniated discs, or degenerative disc disease.

Spinal Stenosis Symptoms

Cramping, weakness, pain and/or tingling in your legs, especially when you walk, are classic symptoms of spinal stenosis. These symptoms are called neurogenic claudication. It's best to speak with your doctor as soon as you can if you experience them.

Your Pain Persists

Has your pain lasted longer than thre weeks? If so, it may be chronic. Chronic pain is pain that lasts longer than the expected healing time for an injury. Once chronic, pain plays by its own set of rules, becoming amplified or otherwise aberrated.

Early diagnosis and treatment are key to managing it well and getting on with your life. The sooner you can get your pain accurately assessed, and treatment started, the better you will likely be in terms of your healing outcomes. 

 

8 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. American Cancer Society. Signs and symptoms of cancer.

  2. Kozinoga M, Majchrzycki M, Piotrowska S. Low back pain in women before and after menopausePrz Menopauzalny. 2015;14(3):203–207. doi:10.5114/pm.2015.54347

  3. Johns Hopkins Medicine. Bladder and bowel dysfunction.

  4. American Association of Neurological Surgeons. Cauda Equina Syndrome.

  5. Alexander CE, Varacallo M. Lumbosacral Radiculopathy. In: StatPearls. Treasure Island, FL: StatPearls Publishing.

  6. University of Maryland Medical Center. Lumbar Herniated Disc.

  7. Ammendolia C, Stuber KJ, Rok E, et al. Nonoperative treatment for lumbar spinal stenosis with neurogenic claudication. Cochrane Database Syst Rev. 2013;(8):CD010712. doi:10.1002/14651858.CD010712

  8. Cleveland Clinic. Acute vs. chronic pain.

By Anne Asher, CPT
Anne Asher, ACE-certified personal trainer, health coach, and orthopedic exercise specialist, is a back and neck pain expert.