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[Sciatica](https://www.healthcentral.com/condition/sciatica) - [Upper Back](https://www.healthcentral.com/condition/back-pain/upper-back-pain) Medically Reviewed # How Do You Know When Back Pain Is Serious? Find out how to spot red flags that can indicate a serious condition. Jun 26, 2020 By [Shelby Deering](https://www.healthcentral.com/author/shelby-deering) Medical Reviewer[Santhosh A. Thomas, D.O., M.B.A.](https://www.healthcentral.com/author/santhosh-a-thomas)  Here's how to tell if your back pain may be something serious ###### Jump To - [Signs of Something Serious](https://www.healthcentral.com/condition/back-pain/how-do-you-know-when-back-pain-serious#signs-of-something-serious) - [Possible Conditions Causing Severe Back Pain](https://www.healthcentral.com/condition/back-pain/how-do-you-know-when-back-pain-serious#possible-conditions-causing-severe-back-pain) - [Spotting the Signals](https://www.healthcentral.com/condition/back-pain/how-do-you-know-when-back-pain-serious#spotting-the-signals) - [Diagnosis and Treatment](https://www.healthcentral.com/condition/back-pain/how-do-you-know-when-back-pain-serious#diagnosis-and-treatment) - [Get Help for Your Back Pain](https://www.healthcentral.com/condition/back-pain/how-do-you-know-when-back-pain-serious#get-help-for-your-back-pain) In many cases, back pain can be as commonplace as a mild headache, a sneeze here and there, or eye strain. In fact, non-specific low back pain is a frequent ailment. One study in *The Lancet* reports that the lifetime prevalence of chronic low back pain is as high as [84%](https://www.sciencedirect.com/science/article/abs/pii/S0140673611606107), making one’s chances of experiencing discomfort at one time or another pretty high. Then there are those other times, when the back pain just doesn’t feel right and your gut is saying that something more is going on. Many people have been known to go to the emergency room when experiencing [low back pain](https://www.healthcentral.com/condition/low-back-pain)—in 2012, a study in *The Spine Journal* found that low back pain accounted for [3\.15% of all emergency visits](https://www.sciencedirect.com/science/article/abs/pii/S1529943011011624) in the United States. When you consider how many conditions can land someone in the ER, that number is fairly substantial. Let’s say that you’re experiencing a significant amount of back pain, wondering, “How do I know if my back pain is serious?” This guide will help you decide if it warrants a trip to your doctor or the emergency room. ## Signs of Something Serious “While back pain is very common and usually benign and self-limiting, there are some signs and symptoms which could indicate a more serious medical condition requiring further evaluation and treatment,” says [Mark Drymalski, M.D](https://www.muhealth.org/doctors/mark-drymalski-md)., medical director of the University of Missouri Health Care’s Comprehensive Spine Center in Columbia, MO. According to Dr. Drymalski these red flags can include: - Persistent fevers - Unplanned weight loss - Blood in the stool or urine - Progressive numbness or weakness in the legs - Inability to urinate or have a bowel movement - Loss of bowel/bladder control - Pain at night - Sexual dysfunction - Balance problems - Pain not alleviated or worsened by different positions - Recent IV drug use - Progressive worsening of pain despite relative rest - Recent trauma Some symptoms can come on suddenly while others can ramp up gradually. There are several conditions that can bring on these so-called red flags. ## Possible Conditions Causing Severe Back Pain Dr. Drymalski also details several conditions that can cause intense back pain, many of which center on the bones or discs. But you also might be wondering, “How do I know if my back pain is kidney-related? Problems with what other organs can cause lower back pain?” #### Sign up for our bi-monthly Chronic Pain Newsletter. Your [privacy](https://www.healthcentralcorp.com/privacy-policy%20) is important to us.  He shares a wide-ranging list of potential conditions that can bring about extreme back pain: - Fractures - Disc herniations - Cauda equina syndrome - Tumors - Disc or bone infections - Kidney infections or kidney stones - Osteoporosis - Spinal instability - Meningitis - Spinal stenosis - Multiple sclerosis - Transverse myelitis - GI ulcers - Thoracic or abdominal aortic aneurysms ## Spotting the Signals Although that list of possible conditions may seem daunting, the important thing to do is to focus on your symptoms and how you’re feeling. Also, be sure to consider any symptoms that you’re experiencing beyond back pain.  Pay attention to severe back pain and other symptoms that appear with it. “Pay attention to the other symptoms in addition to your back pain, especially your bowel/bladder function and leg function,” Dr. Drymalski says. He adds that if you demonstrate any of the above red flag symptoms, if your pain persists and does not appear to be related to movement, or if you have a history of cancer, recent IV drug use, or a vascular disease, you may be at increased risk for serious back conditions. ## Diagnosis and Treatment Dr. Drymalski explains, “If red-flag symptoms are present, urgent, or emergent, imaging, bloodwork, and evaluation may be required, which is best accessed through a local emergency department.” When it comes to seeking a doctor’s diagnosis, the very best thing is to go in as soon as you think something could be wrong, since early and thorough treatment can help you avoid more serious symptoms and conditions. “Early identification and treatment of many of the severe spine conditions, such as meningitis, discitis, and cauda equina syndrome from a disc herniation or mass, is essential to prevent death or a protracted hospitalization in some cases or permanent neurologic impairment, such as permanent leg weakness or bowel/bladder dysfunction, in others,” Dr. Drymalski says. ## Get Help for Your Back Pain While this all may sound dire, you can take comfort in knowing that most low back pain presentations in the ER are benign, according to a [2009](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2982879/) analysis of the National Hospital Ambulatory Medical Care Survey (NHAMCS). The important thing is to stay as calm as you can as you assess your pain and symptoms and rely on medical experts to assist you and get down to the bottom of why you’re feeling the way you are. “Remember that back pain is very common and the vast majority of the time it will be self-limiting and benign. If you are concerned or have red-flag symptoms, emergent evaluation may be necessary," Dr. Drymalski emphasizes. "It is important to always tell your doctor all of your symptoms, even if you don’t know if they are related to your back pain, so your doctor can develop the most appropriate workup and treatment plan for you.” © 2026 HealthCentral LLC. All rights reserved. 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Print [Our Review Process](https://www.healthcentral.com/medical-review-board) [Shelby Deering, Health Writer:](https://www.healthcentral.com/author/shelby-deering) Shelby Deering is a lifestyle writer from Madison, Wisconsin specializing in wellness, mental health, and home design. She’s written for national publications and websites including Talkspace, Prevention, and more. [Santhosh A. Thomas, D.O., M.B.A., Medical Director, Center for Spine Health:](https://www.healthcentral.com/author/santhosh-a-thomas) Dr. Santhosh Thomas is a board-certified physician specializing in back and neck pain, sports medicine, musculoskeletal medicine, and pain management. He also serves as co-director of the medical spine fellowship at the Cleveland Clinic’s Neurological Institute in Ohio.  #### More Like This [Herniated Disc Cervical Herniated Disc or Ruptured Disc Medically Reviewed](https://www.healthcentral.com/condition/herniated-disc/cervical-herniated-disc-or-ruptured-disc) [Back Pain Endoscopic Spine Surgery: What It Is and What It Isn’t](https://www.healthcentral.com/condition/back-pain/endoscopic-spine-surgery-what-what-isn-t) [Herniated Disc Chiropractic Care and Back Pain: Non-Invasive Treatment for Bulging, Ruptured, or Herniated Discs (Slipped Discs) Medically Reviewed](https://www.healthcentral.com/condition/herniated-disc/chiropractic-care-back-pain-non-invasive-treatment-bulging-ruptured-or) [Back Pain Laser Spine Surgery: Help or Hype? Medically Reviewed](https://www.healthcentral.com/condition/back-pain/laser-spine-surgery-help-or-hype) Medically Reviewed # Summer Shoes Can Lead to Back Pain—Here’s What To Do About It Here’s why you probably don’t want to choose flip-flops or sandals if you have back pain. Jun 26, 2020 By [Shelby Deering](https://www.healthcentral.com/author/shelby-deering) Medical Reviewer[Steven Richeimer, M.D.](https://www.healthcentral.com/author/steven-richeimer)  Those flip-flops could be doing a number on your back ###### Jump To - [Why Do Summer Shoes Cause Back Pain?](https://www.healthcentral.com/condition/back-pain/how-do-you-know-when-back-pain-serious#why-do-summer-shoes-cause-back-pain) - [Arches: Fallen vs. High](https://www.healthcentral.com/condition/back-pain/how-do-you-know-when-back-pain-serious#arches-fallen-vs-high) - [How to Find the Right Shoes](https://www.healthcentral.com/condition/back-pain/how-do-you-know-when-back-pain-serious#how-to-find-the-right-shoes) - [Customize Shoes for Back Pain](https://www.healthcentral.com/condition/back-pain/how-do-you-know-when-back-pain-serious#customize-shoes-for-back-pain) As soon as those temperatures rise, you likely can’t wait to break out your shorts, tees, and favorite sandals. For days, you wear your flip-flops wherever you go. Then you notice that your back pain has flared up. Could it be the shoes? It could. Although there are myriad things that can exacerbate back pain (poor posture, muscle spasms, or any number of medical causes), something as everyday as your shoe choice can indeed impact your back. [Studies suggest](https://www.sciencedirect.com/science/article/abs/pii/S1297319X14001456) that unstable shoes—like flip-flops—can lead to [low back pain](https://www.healthcentral.com/condition/low-back-pain). Podiatrists agree that footwear that’s less than supportive can contribute to back discomfort. Dr. Velimir Petkov, D.P.M., of [Premier Podiatry](https://www.premier-podiatry.com/) in Clifton, NJ, explains how something as simple as flip-flops can trigger back pain. “Improper footwear can allow biomechanical abnormalities in the feet to compound and worsen, and therefore lead to increased pain in the knees, hips, and lower back,” he says. As opposed to properly fitted athletic shoes, which are some of the best shoes for lower back pain, many summer sandals offer little to no support. Here’s how that can cause problems, and how to choose the best summer shoes for your body. ## Why Do Summer Shoes Cause Back Pain? As Dr. Petkov stated, issues in your feet can cause a chain reaction that affects your knees and hips, which in turn can affect your back. #### Sign up for our bi-monthly Chronic Pain Newsletter. Your [privacy](https://www.healthcentralcorp.com/privacy-policy%20) is important to us.  It starts with your foot type. Wearing summer shoes can worsen underlying issues you may not even know about in your feet, leading to back pain.  Choose the right shoes to spare your back “In people that have flat feet, it tends to force your muscles and tendons in your feet to overwork, which can lead to [tendinitis](https://www.healthcentral.com/condition/tendinitis),” Dr. Petkov notes. “Also, unsupported fallen arches can lead to developing arthritis in your knees and wearing out of your medial meniscus. When the knees are not functioning properly, that puts additional stress on your hips and lower back, which in turn can lead to degeneration of your [intervertebral discs](https://www.healthcentral.com/condition/back-pain/intervertebral-discs).” ## Arches: Fallen vs. High Dr. Petkov explains that two anatomical anomalies—fallen arches (flat feet) and high arches—can cause back pain in different ways. “[Hyperpronation](https://www.sciencedirect.com/science/article/abs/pii/S1360859217303388), which occurs in flat feet, causes the arches to collapse, and therefore it puts pressure on the inside of the legs and knees, which in turn creates more imbalance in the hips and lower back.” He goes on to say, “On the other hand, [hypersupination](http://www.koreascience.or.kr/article/JAKO200816755695978.page), which occurs in high-arched feet, causes the arches to heighten and therefore it puts pressure on the outside of the legs and knees, which can lead to muscle imbalances on the outside of the legs and also in the hips and lower back.” This means that wearing unsupportive shoes for long periods, like flip-flops, sandals, and most shoes with a heel, can cause back pain or make an existing condition even worse. “When either of these conditions gets left untreated, the compounding effect of pes planus (flat feet) or pes cavus (high-arched feet) can lead to long-term debilitating injury and wear and tear in the spine and especially the vertebrae and the intervertebral discs,” Dr. Petkov says.  Common arch shapes The bottom line? Your footwear choice can greatly influence back pain. ## How to Find the Right Shoes Now you might be wondering, “How do I pick out summer shoes that won’t hurt my back?” First of all, you’ll be happy to know that you don’t have to do away with your beloved flip-flops altogether. “Purchase a shoe or a flip-flop that is sturdy and one that doesn’t bend in the middle of the shoe but only at the level of the toes,” Dr. Petkov advises. If you have flat feet, he says, “Look for a shoe that provides sufficient arch support in order to prevent hyperpronation and the related back pain that can result from it.” Most importantly, when shopping for shoes for back pain, be careful to look at the details. For instance, something as simple as an ankle strap can mean the difference between being in pain and pain-free. “Consider buying sandals that have an ankle strap in order to keep your feet in place," Dr. Petkov shares. "Preventing the feet from slipping out of the sandals provides better stability during longer walks and can also prevent tendinitis in your posterior muscle groups.” Lastly, Dr. Petkov would prefer people to avoid anything with a heel, saying, “Do not purchase sandals or flip-flops that have a high-heel lift. [Increased heel lifts](https://www.sciencedirect.com/science/article/abs/pii/S0169814101000385) force you to shift your center of gravity forward, which forces you to arch your back when standing and that can contribute to back pain.” ## Customize Shoes for Back Pain Let’s say you’d love a pair of flip-flops that are custom-made for you and won’t cause any back pain. Well, you’re in luck, because this is entirely possible with the help of a podiatrist. “You can actually get 3-D scanned by your podiatrist who can order a fully customized, custom-milled flip-flop that will support your arches based on your individual arch 3-D scan,” Dr. Petkov says. So, never fear. You can still wear flip-flops this summer and skip the back pain, too. © 2026 HealthCentral LLC. All rights reserved. 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Print [Our Review Process](https://www.healthcentral.com/medical-review-board) [Shelby Deering, Health Writer:](https://www.healthcentral.com/author/shelby-deering) Shelby Deering is a lifestyle writer from Madison, Wisconsin specializing in wellness, mental health, and home design. She’s written for national publications and websites including Talkspace, Prevention, and more. [Steven Richeimer, M.D., Chief, Division of Pain Medicine:](https://www.healthcentral.com/author/steven-richeimer) Steven Richeimer is a professor of clinical anesthesiology and psychiatry and behavioral sciences at Keck School of Medicine at the University of Southern California (USC) in Los Angeles.  #### More Like This [Osteoarthritis Dream Big: Less Back Pain in 4 Weeks With Osteoarthritis](https://www.healthcentral.com/fitness-and-exercise/dream-big-less-back-pain-with-osteoarthritis-week-1) [Fitness and Exercise 25 Tips for Relieving Holiday Back Pain](https://www.healthcentral.com/fitness-and-exercise/tips-relieving-holiday-back-pain) [Back Pain 12 Exercises for a Pinched Nerve in the Neck or Lower Back Medically Reviewed](https://www.healthcentral.com/condition/back-pain/low-back-pain/best-exercises-pinched-nerve-neck-lower-back) [Back Pain Can an Inversion Table Help Your Back Pain? Medically Reviewed](https://www.healthcentral.com/condition/back-pain/alternative/inversion-table-back-pain) #### Emails That Keep You Healthy\! 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- [Back Pain](https://www.healthcentral.com/category/back-pain) - [Overview](https://www.healthcentral.com/condition/back-pain) - [Back Sprain](https://www.healthcentral.com/condition/back-sprains-strains) - [Herniated Disc](https://www.healthcentral.com/condition/herniated-disc) - [Lower Back](https://www.healthcentral.com/condition/low-back-pain) - [Sciatica](https://www.healthcentral.com/condition/sciatica) - [Upper Back](https://www.healthcentral.com/condition/back-pain/upper-back-pain) Medically Reviewed ## How Do You Know When Back Pain Is Serious? Find out how to spot red flags that can indicate a serious condition. By  Here's how to tell if your back pain may be something serious ###### Jump To - [Signs of Something Serious](https://www.healthcentral.com/condition/back-pain/how-do-you-know-when-back-pain-serious#signs-of-something-serious) - [Possible Conditions Causing Severe Back Pain](https://www.healthcentral.com/condition/back-pain/how-do-you-know-when-back-pain-serious#possible-conditions-causing-severe-back-pain) - [Spotting the Signals](https://www.healthcentral.com/condition/back-pain/how-do-you-know-when-back-pain-serious#spotting-the-signals) - [Diagnosis and Treatment](https://www.healthcentral.com/condition/back-pain/how-do-you-know-when-back-pain-serious#diagnosis-and-treatment) - [Get Help for Your Back Pain](https://www.healthcentral.com/condition/back-pain/how-do-you-know-when-back-pain-serious#get-help-for-your-back-pain) In many cases, back pain can be as commonplace as a mild headache, a sneeze here and there, or eye strain. In fact, non-specific low back pain is a frequent ailment. One study in *The Lancet* reports that the lifetime prevalence of chronic low back pain is as high as [84%](https://www.sciencedirect.com/science/article/abs/pii/S0140673611606107), making one’s chances of experiencing discomfort at one time or another pretty high. Then there are those other times, when the back pain just doesn’t feel right and your gut is saying that something more is going on. Many people have been known to go to the emergency room when experiencing [low back pain](https://www.healthcentral.com/condition/low-back-pain)—in 2012, a study in *The Spine Journal* found that low back pain accounted for [3\.15% of all emergency visits](https://www.sciencedirect.com/science/article/abs/pii/S1529943011011624) in the United States. When you consider how many conditions can land someone in the ER, that number is fairly substantial. Let’s say that you’re experiencing a significant amount of back pain, wondering, “How do I know if my back pain is serious?” This guide will help you decide if it warrants a trip to your doctor or the emergency room. “While back pain is very common and usually benign and self-limiting, there are some signs and symptoms which could indicate a more serious medical condition requiring further evaluation and treatment,” says [Mark Drymalski, M.D](https://www.muhealth.org/doctors/mark-drymalski-md)., medical director of the University of Missouri Health Care’s Comprehensive Spine Center in Columbia, MO. According to Dr. Drymalski these red flags can include: - Persistent fevers - Unplanned weight loss - Blood in the stool or urine - Progressive numbness or weakness in the legs - Inability to urinate or have a bowel movement - Loss of bowel/bladder control - Pain at night - Sexual dysfunction - Balance problems - Pain not alleviated or worsened by different positions - Recent IV drug use - Progressive worsening of pain despite relative rest - Recent trauma Some symptoms can come on suddenly while others can ramp up gradually. There are several conditions that can bring on these so-called red flags. Dr. Drymalski also details several conditions that can cause intense back pain, many of which center on the bones or discs. But you also might be wondering, “How do I know if my back pain is kidney-related? Problems with what other organs can cause lower back pain?” He shares a wide-ranging list of potential conditions that can bring about extreme back pain: - Fractures - Disc herniations - Cauda equina syndrome - Tumors - Disc or bone infections - Kidney infections or kidney stones - Osteoporosis - Spinal instability - Meningitis - Spinal stenosis - Multiple sclerosis - Transverse myelitis - GI ulcers - Thoracic or abdominal aortic aneurysms Although that list of possible conditions may seem daunting, the important thing to do is to focus on your symptoms and how you’re feeling. Also, be sure to consider any symptoms that you’re experiencing beyond back pain.  Pay attention to severe back pain and other symptoms that appear with it. “Pay attention to the other symptoms in addition to your back pain, especially your bowel/bladder function and leg function,” Dr. Drymalski says. He adds that if you demonstrate any of the above red flag symptoms, if your pain persists and does not appear to be related to movement, or if you have a history of cancer, recent IV drug use, or a vascular disease, you may be at increased risk for serious back conditions. Dr. Drymalski explains, “If red-flag symptoms are present, urgent, or emergent, imaging, bloodwork, and evaluation may be required, which is best accessed through a local emergency department.” When it comes to seeking a doctor’s diagnosis, the very best thing is to go in as soon as you think something could be wrong, since early and thorough treatment can help you avoid more serious symptoms and conditions. “Early identification and treatment of many of the severe spine conditions, such as meningitis, discitis, and cauda equina syndrome from a disc herniation or mass, is essential to prevent death or a protracted hospitalization in some cases or permanent neurologic impairment, such as permanent leg weakness or bowel/bladder dysfunction, in others,” Dr. Drymalski says. While this all may sound dire, you can take comfort in knowing that most low back pain presentations in the ER are benign, according to a [2009](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2982879/) analysis of the National Hospital Ambulatory Medical Care Survey (NHAMCS). The important thing is to stay as calm as you can as you assess your pain and symptoms and rely on medical experts to assist you and get down to the bottom of why you’re feeling the way you are. “Remember that back pain is very common and the vast majority of the time it will be self-limiting and benign. If you are concerned or have red-flag symptoms, emergent evaluation may be necessary," Dr. Drymalski emphasizes. "It is important to always tell your doctor all of your symptoms, even if you don’t know if they are related to your back pain, so your doctor can develop the most appropriate workup and treatment plan for you.” - [Share via spu\_article\_nid51029\_page-facebook](https://www.facebook.com/sharer.php?u=https%3A%2F%2Fwww.healthcentral.com%2Fcondition%2Fback-pain%2Fhow-do-you-know-when-back-pain-serious%3Fap%3Dsocs&quote=How%20Do%20You%20Know%20When%20Back%20Pain%20Is%20Serious%3F%20) - [Share via spu\_article\_nid51029\_page-pinterest](https://www.pinterest.com/pin/create/button/?description=undefined&media=&url=https%3A%2F%2Fwww.healthcentral.com%2Fcondition%2Fback-pain%2Fhow-do-you-know-when-back-pain-serious%3Fap%3Dsocs) - [Share via spu\_article\_nid51029\_page-twitter](https://twitter.com/share?url=https%3A%2F%2Fwww.healthcentral.com%2Fcondition%2Fback-pain%2Fhow-do-you-know-when-back-pain-serious%3Fap%3Dsocs&via=HealthCentral&text=How%20Do%20You%20Know%20When%20Back%20Pain%20Is%20Serious%3F%20&hashtags=HealthCentral&related=healthcentral,health_tips,thebodydotcom,wellsphere) - [Share via spu\_article\_nid51029\_page-mail](mailto:?body=I%20saw%20this%20on%20HealthCentral%2C%20and%20thought%20you%20might%20want%20to%20see%20it%2C%20too%3A%0A%0AHow%20Do%20You%20Know%20When%20Back%20Pain%20Is%20Serious%3F%20%20%20%0A%20%20%0Ahttps%3A%2F%2Fwww.healthcentral.com%2Fcondition%2Fback-pain%2Fhow-do-you-know-when-back-pain-serious%3Fap%3Dsocs%0A%20%20%0AAt%20HealthCentral%2C%20chronic%20meets%20community.%20We%E2%80%99re%20here%20to%20help%20you%20live%20your%20best%20life.%20Visit%20us%20and%20sign%20up%20for%20our%20free%20newsletter%20at%20HealthCentral.com.) 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