I'm really concerned that my wife's back pain could be something serious. She refuses to see a doctor. Is there anything you can tell me that would help me judge whether or not this is more than just an ongoing back ache?

Most low back pain (LBP) isn't serious and will go away on its own. The cause of the pain often remains a mystery. Even with all of today's technology and advanced imaging available, there seems to be no clear cause of LBP for many patients.

But doctors do look for what they refer to as red flags. These are signs that something more serious is going on and needs closer attention. Some of these red flags are signs and symptoms the patient reports. Others are part of the patient's medical history.

A few of the more common findings that require medical attention include:

  • Back pain in an adult age 50 or older
  • Constant, intense pain that's worse at night
  • Back pain after long-term use of corticosteroids
  • Loss of bladder or bowel control
  • Skin rashes, inflammation of the eye, or colitis
  • Past history of cancer (any kind, anywhere in the body)

    A medical exam will reveal any deformities or loss of motion. The doctor will look for other signs that something more than ordinary back pain is present. X-rays are not routinely taken because the results can be perfectly normal in someone with chronic back pain. But if there are any suspicious red flags, then the physician may investigate further.

  • Reference: 

    Bill H. McCarberg, MD, and Gladstone C. McDowell II, MD. Recent Advances in the Management of Chronic Low Back Pain. In Pain Medicine News. November 2007. Vol. 5. No. 6. Pp. 71-76.

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