A second concerning situation is called cauda equina syndrome. This can happen when a disc herniation in the low back is so big it fills the entire spinal canal. The immediate pressure on the nerves in the spine may cause paralysis of the muscles that control the bowels and bladder. People with back pain who lose control over their bowels or bladder should contact their physician immediately. This requires immediate medical attention because if the pressure is not removed, the nerves to the bowels and bladder can be permanently damaged.

Pain or symptoms that start for no apparent reason may also be a "red flag." Pain can begin from many sources. Pain originating from the kidneys can spread pain into the mid to low back. A problem gall bladder can radiate pain into the mid back and right arm. Other causes of pain that is felt around the spine can include aortic aneurysm and stomach ulcers. So when spine pain or symptoms start without known injury or trauma, it can be a signal that other concerning problems may be involved. Additional tests and questions may be done to rule out other causes of spine pain. Blood tests can be done to check for infection or arthritis. X-rays can rule out tumors or cancer. Your doctor may want to know whether you've had any recent weight loss or weight gain, whether your pain wakes you up at night, and whether your pain changes as you move or rest. Ruling out concerning factors of spine pain can bolster your confidence and help you in the healing process.