Back pain is incredibly common—80% of people have it at some point—and it’s usually nothing to worry about. Most of the time it’s caused by a muscle sprain or strain or a herniated disc, and there’s a solid chance that it will get better on its own, says Allen Chen, MD, Assistant Clinical Professor of Rehabilitation and Regenerative Medicine at Columbia University Medical Center in NYC. If your ache started recently, you might not even need to see a doctor or take a pill: Non-invasive treatments like massage, exercise, and yoga (try these 7 poses) will often do the trick, according to the latest guidelines from the American College of Physicians. (Looking to take back control of your health? Prevention has smart answers—get a FREE book when you subscribe today.)
That said, sometimes back pain is your body’s way of telling you that something is majorly off, and that you ought to call for help right away. The following red flags are clues that it’s time to call your doctor—or possibly head to the ER.
It could be cauda equina syndrome, a rare disorder—it affects only about 1 in 33,000 people—in which the nerve roots in your lumbar spine become compressed, cutting off all sensation and movement. “I’ve only seen two patients with back pain who had it in my entire 24-year career, but both needed surgery within the day,” says Matt Likins, PT, owner of 1st Choice Physical Therapy in Detroit. If you don’t get surgery ASAP, it can lead to paralysis, complete loss of bladder and/or bowel control, and sexual dysfunction.