3 ways your back pain might indicate something serious

Back pain is a common problem, affecting 80 percent of people at some point in their lives. Everyone’s discomfort is different, though, and some signs and symptoms are more worrisome than others.

Getting regular exercise, maintaining a healthy body weight, practicing good posture and doing your best to avoid spinal injury all decrease your risk for spinal arthritis and other back-related issues.

Most often, back pain results from strains that occur from overworking muscles or tendons in the back. Even small movements — like twisting or stretching too far, lifting something improperly or trying to pick up an item that's too heavy — can result in a strain.

When tissues stretch or tear, symptoms ranging from a dull ache to sharp pain to a burning sensation in the affected area can result. The discomfort might last anywhere from a few days to a few weeks. Acute pain from strains will typically subside on its own. You can manage acute pain from strains with rest, ice, heat and over-the-counter pain relievers such as acetaminophen, ibuprofen or naproxen.

However, severe back pain and back pain that persists for several weeks should be evaluated by a healthcare provider. When back pain begins with no discernible cause and doesn’t go away on its own, it could be linked to a serious spinal issue.

Seek immediate attention if your back pain:

• Comes with bowel or bladder problems
• Sudden or severe headaches
• Neurological issues
• Vision problems
• Sudden arm or leg pain with weakness, numbing or tingling

Below, you can learn more about which types of back pain and related symptoms may indicate serious conditions.

For personalized recommendations about your neck and back health, take our free, confidential back and neck pain assessment

Back pain related to leg pain and weakness

One condition that may indicate a more serious problem is sciatica, which is pain that originates in the lower back and travels down the legs. Underlying causes of sciatica may include a herniated disk or spinal stenosis. Both conditions cause the space around the spinal nerves to narrow, which may result in nerve pain and irritation.

If you have sciatica, pain in your back and through the back of your legs may be dull or severe, can come in bursts and worsened by coughing or sneezing. Discomfort caused by a herniated disk typically travels down one side of the body. Spinal stenosis typically affects both legs, sometimes in their entirety. It tends to worsen with standing and walking and often eases with sitting down and bending forward.

Pain caused by sciatica or a herniated disk will usually improve in six to eight weeks without surgery. But if pain in the arms or legs lasts longer than a week, becomes severe, or is accompanied by muscle weakness or difficulty controlling your bowels or bladder, seek immediate medical attention. Your doctor/specialist will diagnose the condition with a physical exam and may recommend imaging tests, including X-rays or magnetic resonance imaging (MRI).

Depending on the cause of the pain, your doctor/specialist may prescribe ice or heat, over-the-counter pain medications, exercise, physical therapy, steroid injections or even surgery.

Back pain and incontinence

If you have back pain, and also are having trouble emptying your bladder or going to the bathroom, you should get immediate medical attention. 

Bladder or bowel incontinence may be signs of nerve compression caused by a ruptured disk. If left untreated, nerve compression can lead to permanent nerve damage.

Back stiffness and arthritis

Getting out of bed isn’t always easy, but excessive morning back pain and stiffness could be a sign of spinal arthritis. Most types of arthritis – osteoarthritis and rheumatoid arthritis – cause pain and stiffness that worsens toward the end of the day and after periods of rest, like a night’s sleep.

Any part of the spine can become arthritic, but the lower back (lumbar region), is most commonly affected. Untreated spinal arthritis can lead to excruciating pain, stiffness and a decreased range of motion. Thankfully, there are ways to manage the condition. Once diagnosed using a physical exam and X-ray imaging, spinal arthritis can be treated with pain medication and physical therapy. Surgery is needed in rare cases.

This blog was originally written for HCA Healthcare’s Healthy Living series and was medically reviewed and repurposed for HCA Healthcare Capital Division in 2024.