Back pain is a common experience, affecting many individuals at some point in their lives. While often a result of muscle strain or injury, the sudden onset of back pain accompanied by fever can be a more concerning sign. However, when these two symptoms appear together, they can indicate an underlying medical condition requiring prompt attention.
Why Back Pain Alone Does Not Cause Fever
Typical back pain, such as that caused by muscle strains, ligament sprains, or disc issues, is generally mechanical in nature. This type of pain originates from localized damage or irritation to musculoskeletal structures. The body’s response involves local inflammation, which aids healing, but it does not trigger a systemic fever. Fever is a broader physiological response, indicating the body’s immune system is actively fighting a widespread infection or significant inflammatory process. It involves an increase in core body temperature. Mechanical back pain, even if severe, does not stimulate the systemic immune pathways necessary to produce a fever.
Conditions That Cause Both Back Pain and Fever
When back pain and fever occur together, it often points to an underlying infection or inflammatory condition. These conditions vary in severity and can involve various organ systems. Prompt diagnosis is important to prevent potential complications.
Spinal infections, though rare, are serious and include osteomyelitis, discitis, and epidural abscesses. Vertebral osteomyelitis, an infection of spinal bones, can cause severe back pain, fever, chills, and sometimes weight loss. Discitis involves infection and inflammation of intervertebral discs, causing severe back pain that worsens with movement, often with fever and chills. A spinal epidural abscess is a collection of pus near the spinal cord, causing severe back pain, fever, and chills. These spinal infections can spread from other body parts through the bloodstream, sometimes originating from urinary tract infections or dental procedures.
Infections outside the spine can also manifest with back pain and fever. Kidney infections (pyelonephritis) frequently cause lower back or side pain, high fever, chills, and painful or frequent urination. These infections typically begin as a urinary tract infection (UTI) and spread upwards. Systemic infections like influenza or severe colds can also cause widespread body aches, including back pain, alongside fever.
Inflammatory conditions, while not always infectious, can also cause both back pain and fever. Ankylosing spondylitis, a type of arthritis, primarily affects the spine, causing chronic back pain, stiffness, and sometimes a mild fever during flare-ups. This condition involves inflammation that can lead to stiffness and pain.
Recognizing Warning Signs and When to Seek Medical Help
Certain symptoms accompanying back pain and fever serve as warning signs necessitating immediate medical evaluation. These “red flag” symptoms suggest a potentially severe underlying condition. New neurological deficits, such as sudden weakness, numbness, or tingling in the arms or legs, warrant urgent medical attention.
Loss of bladder or bowel control is a critical warning sign, indicating potential spinal cord compression. Severe, persistent back pain that does not improve with rest, especially if worsening at night, combined with fever, also warrants a healthcare visit. Other concerning symptoms include unexplained weight loss, a stiff neck, or recent back injury.
What to Expect When Seeking Medical Help
When seeking medical help for back pain and fever, a healthcare provider will typically begin with a comprehensive evaluation. This includes a detailed medical history to understand your symptoms and their onset. A thorough physical examination will follow, assessing your range of motion, muscle strength, reflexes, and checking for tenderness or swelling in the back.
Various diagnostic tests may be ordered to determine the underlying cause. Blood tests are common to check for infection or inflammation, such as elevated white blood cell counts or inflammatory markers. Urine tests may be performed to rule out urinary tract or kidney infections. Imaging studies like X-rays, MRI, or CT scans are often used to visualize the spine and surrounding tissues for abnormalities like infections, abscesses, or structural issues. MRI is considered a primary tool for evaluating spinal infections. The goal of these diagnostic steps is to accurately identify the cause of your symptoms for effective and timely treatment.