Back Pain Red Flags You Should Not Ignore

Understanding back pain and why red flags matter

Back pain is common and most episodes improve with time, movement, and sensible care. However, a small number of cases indicate more serious causes that need earlier assessment. “Red flags” are warning signs that mean your GP should review you sooner to rule out problems such as fracture, infection, major nerve compression, inflammatory disease, or cancer spread.

When back pain needs urgent or same-day medical assessment

Seek urgent medical review if back pain occurs with:

• difficulty controlling bladder or bowel, leakage, or loss of sensation

• numbness or tingling around the groin or inner thighs (“saddle numbness”)

• severe leg weakness, sudden difficulty walking, or foot drop

• severe pain after trauma or a fall (particularly in older adults)

• fever, feeling very unwell, or spreading redness with back pain

These may signal serious spinal or nerve problems.

When to call for emergency help in Australia

Call Triple Zero (000) immediately if someone has:

• collapse, fainting, or sudden paralysis

• severe trauma

• rapidly worsening neurological symptoms

• severe uncontrolled pain with worrying symptoms

If unsure, it is safer to seek urgent help.

When back pain needs timely GP review (soon, but not an emergency)

Book a medical review if your back pain involves:

• unexplained weight loss, night sweats, or persistent night pain

• pain that is not improving after several weeks

• pain in people with a history of cancer, immune suppression, osteoporosis, or steroid use

• pain after even minor trauma in older adults

• new back pain in children

These signs do not always mean serious illness, but they deserve assessment.

Inflammatory back pain — a different pattern

Seek review if you notice:

• morning stiffness lasting longer than 30 minutes

• pain improving with movement rather than rest

• alternating buttock pain

• symptoms starting before age 45 and persisting

Early diagnosis supports better outcomes.

Back pain during pregnancy

Back and pelvic pain can occur in pregnancy, but sudden severe pain, neurological symptoms, fever, trauma-related pain, or concerns should be reviewed promptly. Your GP or maternity provider will guide safe assessment.

What is usually normal and reassuring

Common back pain often:

• improves gradually over days to weeks

• eases with regular movement and gentle activity

• relates to muscle strain, posture, lifting, or strain

• settles with sensible self-care

Most people recover without needing scans or long-term treatment.

Lifestyle and self-care for non-red flag back pain

Helpful strategies include:

• staying gently active rather than prolonged bed rest

• stretching and movement within comfort

• heat packs for muscle tightness or spasms

• safe short-term pain relief as guided by your GP or pharmacist

• good sleep, pacing activity, and manageable lifting habits

Physiotherapy, exercise physiology, and strengthening programs can help prevent recurrence.

Where your GP fits

Your GP listens to your symptoms, examines your back and nervous system, and decides whether tests are necessary. Not every case needs a scan — decisions are guided by safety, examination, and symptom pattern. Referral to physiotherapy, pain specialists, orthopaedics, neurosurgery, or rheumatology may be recommended depending on the cause.

A reassuring message

Most back pain improves with movement, time, and support. Knowing red flags simply helps you seek medical care sooner when it matters.

This article provides general health information only and does not replace medical advice. Please speak with your GP for personalised care.