Your back hurts. So what? Everybody has a little back pain now and then.
But what if it could kill you?
Most people suffer back pain as the result of daily stresses on the structural support of the body: the bones, discs, muscles, and ligaments in and around the spine. Just as a car gets rusty with age, the human body succumbs to the effects of gravity over the years. Aches and sprains, muscle pulls and strains, are part of life from middle-age onward.
However, back pain may be the result of other abnormalities within the body, several of which can cause death, whether in minutes or years. It’s wise to think twice when your back starts hurting. Was it too much yardwork over the weekend or perhaps something else?
Here are 7 potentially fatal causes of back pain:
1. Aortic aneurysm. The large artery that carries blood away from the heart sometimes weakens with age and balloons outward, like a weak spot on a tire. If the aorta ruptures, massive internal bleeding may occur, sometimes causing death within minutes. Fairly often the pain from a damaged aorta is felt the back. If the vessel is stretching slowly with time, the pain may be chronic or intermittent in nature. If the vessel is rupturing quickly, the pain is usually intense and accompanied by other symptoms such as weakness, abdominal pain, and faintness. If you have a strange back pain, different than your usual pattern, it’s best to consult your doctor. If the pain is abrupt and severe, call 911.
2. Cancer and tumors. Both cancer originating in the bones of the back and cancer that spreads to the back from another location commonly cause back pain. A benign tumor of the spinal cord and vertebrae may also produce pain, as the enlarging mass presses on sensitive structures. The pain may occur with movement or at rest, but tends to worsen over time and may be severe. Any back pain that persists or worsens with time should be professionally evaluated.
3. Infection. When bacteria invade the deep structures of the body, such as the bones, discs, and spinal cord, serious infection may ensue. These infections are fairly uncommon and may go unrecognized until the process is quite advanced. Kidney and lung infections may cause back pain as well, and are often dismissed as nothing more than a back strain. When any of these conditions is untreated, bacteria may enter the blood stream and cause sepsis, a potentially fatal infection of the blood. When infection is the cause of back pain, other symptoms may be present as well, for example fever, nausea, and sweating. Again, see your doctor if these symptoms occur.
4. Pancreatitis. When the pancreas becomes inflamed for whatever reason, the enzymes that are designed to help digest your food may begin digesting your own body instead. Usually this produces nausea, loss of appetite, and abdominal pain, but may produce back pain as well. Pancreatitis may cause internal bleeding, dehydration, elevated blood sugar, electrolyte imbalance, dehydration, and death. Alcohol abuse and gallstones are among the common causes. Call your doctor or go to the ER if you experience these symptoms.
5. Penetrating ulcer. Just as pancreatic juices may eat through the pancreas and other abdominal structures, so may stomach acid burn a hole through the duodenum or stomach. When this happens, internal bleeding occurs and the stomach contents spill into the abdominal cavity, where they cause further destruction and infection. The pain of an ulcer may be felt in the abdomen, the chest, or the back. Heartburn or stomach pain in association with back pain may be an indication of an ulcer and should be evaluated by a physician.
6. Inflammatory bowel disease. When the colon is inflamed the pain may be experienced in the abdomen, pelvis, or back. Inflammation may cause the bowel to perforate, similar to an ulcer, or cause a bowel obstruction. Either of these conditions is potentially fatal. Seek professional care for any abdominal pain accompanied by back pain.
7. Pulmonary embolism. Blood clots usually form deep inside the legs, where they may cause leg swelling, discomfort, and sometimes redness. When a clot dislodges and moves upward through the heart into the lungs, chest pain and/or back pain may occur, usually along with difficulty breathing. If the clot is large, it may obstruct air exchange and result in too little oxygen in the blood. Sudden onset of back pain associated with difficulty breathing may be a pulmonary embolism (blood clot in the lungs) or even a heart attack. Don’t drive yourself to the hospital – call 911.
The above examples illustrate that not all back pain is a simple matter. Fortunately, all of these conditions are fairly rare. If you’ve found your symptoms on the list, seek prompt medical attention.
On the other hand, if you have the same back pain that you get every time you weed your garden or mop the floor, take an aspirin and call your doctor in the morning.
Copyright 2010 Cynthia J. Koelker, M.D.
