Back Pain and Medical Attention. Most cases of back pain are innocuous and caused by muscle strain, usually resolving within a few days on its own. However, there are rare cases which warrant more serious concern. Being able to distinguish between regular backache and dangerous back pain can be life-saving.

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These are some red flags which signal that back pain might be caused by more serious health issues.

1. Pain is persistent, constant and unremitting

Most regular backaches are felt at the end of a day, or after vigorous activity. They are usually relieved by rest. But if your pain has lasted for several weeks or more and affects you even at night when sleeping, or when you are at rest, you should see a doctor. It could be a symptom of a spinal tumour.

2. You feel pain even when you did not fall down

It is normal to experience pain and bruising after a fall. What’s not normal is feeling severe and persistent pain even if you have not injured yourself. This is another possible symptom of a spinal tumour.

3. You had a recent accident

Perhaps you experienced a fall or were involved in an accident, but did not seek medical attention at the time. You might have sustained injuries which were more severe than you realised, such as fractures of the spine.

4. Pain spreads beyond the initial affected area

Is the pain in your back accompanied by tingling in your limbs, numbness, weakness, loss of coordination, pins and needles, as well as cold and hot sensations in your arms or legs? If so, these could be symptoms of nerve damage.

5. You have had cancer or other health issues

An unexplained sore back might be related to unresolved health issues, even if you think that you have fully recovered. The spine is a hotspot for metastatic cancer. Cancers of the lung, breast and colon are the most likely cancers to travel to the spine and manifest as spinal tumours.

6. You had a fever and severe back pains after undergoing surgery or an invasive medical procedure

The presence of fever usually indicates that there is an infection. Bacteria might have entered the bloodstream and spread to the spine, causing a spinal infection.

7. When a younger person complains of a persistent sore back

Children rarely complain of persistent pains. Immediate medical attention is required when a child experiences nighttime pain, constant pain for more than several weeks, pain with fever, or radicular pain. An orthopaedic surgeon will evaluate the patient for tumours, infections, injuries or other illnesses.

8. When an older person complains of persistent back pain

Individuals who are older than 60 are more likely to suffer from pain related to degeneration of the joints in the spine. Two of the most common causes of back aches in seniors are osteoarthritis and spinal stenosis. When back pain is associated with hunching in the elderly, spinal fractures due possibly to osteoporosis need to be excluded.

This article has been verified medically by Dr Tan Seang Beng, orthopaedic and spine surgeon at Orthopaedic And Spine Clinic, Mount Elizabeth Novena Hospital (Singapore).