Red Flag Symptoms
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The vast majority of back problems improve on their own or with nonsurgical treatment. There are a few warning signs, however, that may indicate serious spinal problems. If you experience any of these symptoms, seek medical attention immediately.
Loss of control of the bowel or bladder and retention of urine may indicate damage to the spine's cauda equina nerves. The cauda equina is a bundle of nerves in the low back where the spinal cord ends. Damage to these nerves can be permanent if not treated immediately (within a day or so). See a spine specialist, or go to an emergency room if necessary.
Weakness or numbness in a leg or arm, especially if it is severe—and it is getting worse—also points to nerve damage. This includes "foot drop," a condition where the muscles of the leg and foot are too weak to raise the foot up as the individual attempts to walk. Again, nerve damage associated with these symptoms can be permanent if not treated immediately. This problem should be seen within 24 hours by a spine specialist.
Numbness, pain or tingling that radiates into the arm or leg is also a source for concern and should be seen within a few days by a spine specialist.
High fever accompanied by back pain may indicate a possible infection of the spine and should be treated within 24 hours.
Rules of Thumb on Symptoms
Here's an encouraging back fact: 80 percent of the time, back and neck pain is simply a result of strain or soft tissue injury. In many of these simple cases of back or neck strain, your condition will improve with specialized exercises, rest, and anti-inflammatory medicine. Other times, you may need to see a doctor, perhaps even as soon as possible. Briefly, here are some rules of thumb to keep in mind about your back or neck problems:
- Trauma - If you fall down,
are in a car accident, or do anything abrupt that may have fractured
your back, go to a spine specialty clinic within 24 hours.
- Radicular pain - Anytime
you have back or neck pain that radiates down into your leg or arm,
you probably need to be evaluated by a spine specialist within two
to three days, especially if it is getting worse.
- Persistent pain - If pain
limited to the low back or neck area does not begin to subside after
three days with anti-inflammatories and rest, then you probably need
to be evaluated by a spine specialist. For example, if you first noticed
back or neck pain on Monday, and it's now Thursday, and it's not getting
better, it's time to see a spine specialist to find out what is causing
- Anytime you experience loss of
control of your bowel or bladder, that is an EMERGENCY signal
that you need to see a spine specialist THE SAME DAY. If you wait
too long, you could suffer permanent paralysis of the nerves that
control these functions.
- Foot drop - If you notice
that your toe is dragging as you walk, this is a DANGER SIGNAL for
serious neurological problems. Again, if you delay, you could experience
permanent damage. This problem should be seen within 24 hours by a
- Weakness, numbness or pain that extends below a knee or elbow is a serious symptom. Go to a spine center within two days.
TriCities Spine in Bristol, TN is a by-product of discussions with case managers, rehab nurses and managed care experts on a local and national level who believe that spine care can be improved through a multidisciplinary team approach. TriCities Spine includes a board-certified neurosurgeon who specializes in spine, Dr. Jim Brasfield, teamed with a pain management specialist and spine-specialized physical therapy. TriCities Spine physicians already see a variety of complex cases from across Eastern Tennessee, Virginia, North Carolina and Kentucky. TriCities Spine emphasizes a nonsurgical approach to back pain, recognizing that in most cases spine surgery should be the last card to be played after nonsurgical options have been tried. About half of patients are referred to TriCities Spine by other doctors in the region. TriCities Spine also cares for those who injure themselves at the workplace. The strength of TriCities Spine lies in the medical expertise brought in by a variety of specialists who complement each other, including experts in physical medicine and neurosurgery. An internal pain specialist is often able to relieve some back and neck pain symptoms with special injections that enable a patient to bridge to therapy. Dr. Fred Terry specializes in pain relieving lumbar spinal injections and as well as myelograms, which may reveal the amount of damage in the spine. Therapists who specialize in spine use customized hands-on treatments to relieve pain symptoms, along with special exercises to help make the back stronger, more flexible and resistant to injury. If nonsurgical treatments are not successful, Dr. Jim Brasfield is trained and proficient in the latest techniques in minimally invasive spine surgery. Because of the minimally invasive techniques used by Dr. Brasfield, many patients are able to have their spine surgery and then return home the same day to recover in the comfort of their own home.