UrgentEmergency Guide
Back pain: Red Flags & Emergency Signs
Red-flag back pain — including tearing pain with hypotension, progressive lower limb weakness, or saddle anaesthesia — requires same-day emergency imaging.
🚨 Call 999 / 112 Immediately
- ⚠Sudden tearing back pain with hypotension in a patient over 60 — ruptured aortic aneurysm
- ⚠Back pain with saddle anaesthesia, leg weakness, or bladder/bowel dysfunction — cauda equina syndrome (MRI within 4 hours)
- ⚠Back pain with fever, night sweats, and weight loss — spinal infection (discitis, epidural abscess) or malignancy
⚡ See a Doctor Today
- •Progressive neurological deficit below the level of back pain — spinal cord compression (oncological emergency)
- •New back pain in a patient with known cancer — metastatic spinal cord compression
High-Risk Combinations
When back pain occurs together with any of these symptoms, urgency increases significantly:
Conditions to Rule Out Urgently
Ruptured Abdominal Aortic Aneurysmemergency
CT aortogram; direct to vascular surgery if shocked
Cauda Equina Syndromeurgent
MRI spine within 4 hours; emergency surgical decompression
Metastatic Spinal Cord Compressionurgent
Dexamethasone 16mg + MRI whole spine; oncology/neurosurgery
Spinal Epidural Abscessurgent
MRI spine + blood cultures; IV antibiotics + surgical drainage
Condition Authority Pages
Differential diagnosis analyses:
When to Call Emergency Services
- →Sudden tearing back pain with sweating and collapse
- →Back pain with sudden inability to walk or feel saddle area