Low back pain: Signs of serious problems

Photo of an orthopedic surgeon and a patient with low back pain

Low back pain usually doesn't have a clear cause, isn't dangerous and goes away on its own. Only rarely is it caused by a serious problem such as a broken bone or . It is often possible to tell based on particular symptoms.

The following may be signs of a serious health problem. If you have low back pain together with one or more of these symptoms, you should have a doctor give you a careful examination:

  • Low back pain that radiates down to below your knee or into a foot and is accompanied by numbness, tingling or paralysis: This kind of radiating pain may be a sign of potential damage to nerves that leave the spinal cord at the base of the spine.
  • Problems with urination or bowel movements: These symptoms, as well as numbness around the buttocks (perineum and anus), can be signs of potential damage to the nerves in the tailbone area. This is a medical emergency and requires immediate medical attention.
  • Fever or chills: Both of these symptoms may occur in connection with a spinal .
  • Unexplained weight loss, physical weakness and pain that gets worse when you lie on your back: These symptoms may be a sign of a tumor. This may be a benign (non-cancerous) or malignant (cancerous) tumor around the spine, or metastases that have spread from malignant tumors elsewhere, for example breast cancer or prostate cancer.
  • Low back pain after an accident.
These symptoms don't necessarily mean that you have a serious condition. The likelihood of it being something serious can only be properly assessed after seeing a doctor. Your overall health will play a role here, as well as your age and risk factors for certain diseases such as osteoporosis.

Bundesärztekammer (BÄK), Kassenärztliche Bundesvereinigung (KBV), Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften (AWMF). Nationale Versorgungsleitlinie Nicht-spezifischer Kreuzschmerz (in Überarbeitung). AWMF-Registernr.: nvl-007. 2017.

IQWiG health information is written with the aim of helping people understand the advantages and disadvantages of the main treatment options and health care services.

Because IQWiG is a German institute, some of the information provided here is specific to the German health care system. The suitability of any of the described options in an individual case can be determined by talking to a doctor. informedhealth.org can provide support for talks with doctors and other medical professionals, but cannot replace them. We do not offer individual consultations.

Our information is based on the results of good-quality studies. It is written by a team of health care professionals, scientists and editors, and reviewed by external experts. You can find a detailed description of how our health information is produced and updated in our methods.

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Updated on December 5, 2022

Next planned update: 2025


Institute for Quality and Efficiency in Health Care (IQWiG, Germany)

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