When Back Pain Needs a Doctor, Not a Chiropractor
A short list worth knowing, including the symptoms that mean today rather than next week.
Most back pain is mechanical and gets better. A small number of presentations are not, and part of what an assessment is for is separating the two.
Go to A&E Today
Numbness around the saddle area, difficulty passing urine or loss of control of bladder or bowel, or progressive weakness in both legs. This combination can indicate cauda equina syndrome, it is a surgical emergency, and it is the one thing on this page that should not wait for an appointment with anybody.
See Your GP First
Back pain with unexplained weight loss, night pain that wakes you and does not ease with position change, fever, or a history of cancer. Also any significant trauma, particularly with osteoporosis or long-term steroid use.
Worth Mentioning But Not Alarming
Pain travelling below the knee, pins and needles in a specific area, or symptoms that have not shifted at all in six weeks. These change how we assess and treat, and none of them means anything sinister on their own.
What We Do With This
Every assessment screens for the above, which is a good part of why the first appointment is forty-five minutes rather than twenty. About one new patient in twelve leaves with a referral rather than a treatment plan.