You’re writhing in your bed. You woke up and your back pain is out of control. It hurts to move. It hurts to breathe. You are scared. Rightfully so. Unsure what to do and if the pain might kill you.
It feels like it might sometimes, I know I’ve been there. Laying in bed with the pain so bad I wasn’t sure if it would ever stop. Wanting to cut off body parts, wondering where my life went and if I would ever get it back. Desperately wanting to go to the ER and have them do something, anything.
Over close to 20 years, I learned ER visits were usually unhelpful and demoralizing. I felt ignored, treated like a drug seeker, and disbelieved. So I stopped going. I want you to know, these weren’t bad Doctors or uncaring people. The ER is a place for emergencies. Sadly the reality is while the back pain feels like it might kill us, it isn’t a life-threatening emergency. And the ER is a place where they treat life-threatening emergencies, not a place for pain management.
So when should you go to the ER, when IS the back pain something that needs to be looked at? Read on to find out when the ER is a trip worth making.
There are Red Flags, or certain symptoms that you should not ignore and should go immediately to the ER.
Red Flags You Shouldn’t Ignore
Be sure to keep in mind the red flags for back pain that include:
- Severe pain anywhere, with vomiting, nausea, fever, or changes to your consciousness – call an ambulance and get medical care immediately.
- If you, lose control of your bladder or bowels (incontinence), lose feeling (numbness) in the saddle area. This may indicate cauda equina syndrome.
- Loss of power or sensation in your legs and you are unable to move them.
- Trauma: If you have a fall, a car accident, you hit your head, slipped down the stairs, crashed your bike, or other major incident and you have pain and symptoms like the ones listed above.
While it’s not unreasonable to expect to leave the emergency department with some relief from your pain, you will probably be disappointed. Getting good help for chronic pain (or acute flare-ups of ongoing pain) is not what the ER is designed for. Even if your back, neck, or other pain is severe, there’s only a small chance that it’s a medical emergency.
You can use this as a checklist for considering a trip to the ER
- Prolonged use of Corticosteroids
- History of IV drug use
- History of Cancer
- Incontinence
- Dizziness, Nausea, or vomiting
- Legs weak, numb, or unable to move
- Recent Surgery or Illness
- Recent significant Trauma at any age
- Ejection from motor vehicle
- Fall from a substantial height
If you would say no to the list above, it is unlikely the ER is going to be a helpful place for your pain. Your best plan of action is to create a plan for flare-ups before they happen so you are ready. Put your plan in place and then make an appointment with your primary care physician if you feel you need to have medications adjusted
I know it’s hard and you just want relief. That’s completely reasonable.
For a better way to handle these crazy difficult times, create a flare plan. In my class Managing Flares, I will walk you through everything you need to know to make and implement one. Go get it and get help now!
References:
- Stone C Keith, Humphries R. CURRENT Diagnosis and Treatment Emergency Medicine, Seventh Edition, Chapter 21. McGraw Hill Professional; 2011.
2. Kasper D, Jameson J Larry, Hauser S, Loscalzo J, Fauci A, Longo D. Harrison’s Principles of Internal Medicine 19/E (Vol.1 & Vol.2) Chapter 22. McGraw-Hill Education / Medical; 2015.
