Spinal pain is very common and is usually mechanical and manageable, but there are some warning signs that mean medical review is needed more urgently. Understanding the difference between red flags and more typical back or neck pain can make decisions about seeking help feel clearer.
Red flags – seek urgent medical advice
Contact a doctor or urgent service promptly if spinal pain is present with any of the following:
- Recent significant trauma (for example a fall from height, road‑traffic accident) or even minor trauma in someone with osteoporosis.
- New problems with bladder or bowel control, difficulty starting urination, or numbness around the groin, genitals or anus (saddle area).
- Progressive weakness, numbness or tingling in both legs or both arms, or difficulty walking, standing or coordinating movements.
- Fever, feeling systemically unwell, unexplained weight loss, or a history of cancer, infection, IV drug use or significant immune suppression.
- Sudden, severe spinal pain that is very different from your usual episodes, especially if it came on at rest or at night and does not ease with movement or simple pain relief.
When same day assessment is sensible
Arrange a prompt (but not necessarily emergency) medical review if:
- Pain is getting steadily worse over days to weeks rather than slowly improving.
- Pain began after a minor incident but you now notice increasing weakness, clumsiness or spreading neurological symptoms.
- Spinal pain appears in someone over 50 with no clear trigger, or in a child, especially if it persists.
Features of typical mechanical spinal pain
Mechanical spinal pain is very common and usually improves over time with movement, sensible activity and good support. It often has some of these characteristics:
- Clear links with movement or position – worse when bending, twisting, lifting, sitting or standing for long periods, and often better when changing position or gently moving.
- Localised ache or stiffness in the neck, mid‑back or low back, sometimes with pain referring into the buttock, shoulder or thigh but without severe or rapidly worsening weakness.
- Symptoms that fluctuate – some better and some worse days – but gradually trend in the right direction over a few weeks with pacing, activity modification and simple exercises.
When to see a manual therapist or GP routinely
Even when there are no red flags, it is reasonable to seek help if pain:
- Has lasted longer than a few weeks and limits work, sleep or daily activities.
- Keeps recurring in similar patterns and you want guidance on movement, strength work and prevention.
- Leaves you feeling anxious or unsure about what is safe to do; good assessment, explanation and a plan can be very reassuring.
If in doubt, especially with new or changing symptoms, it is always safer to discuss your situation with a healthcare professional who can take a full history and examine you in person.
