When back pain is accompanied by a fever, it signals a significant concern that warrants immediate attention. This combination of symptoms often suggests an underlying infection or an inflammatory process within the body. The presence of fever alongside back pain indicates conditions far more serious than typical musculoskeletal issues and requires medical evaluation.
Infections as a Cause
Kidney infections, medically known as pyelonephritis, commonly present with pain in the lower back or side, accompanied by fever and chills. These infections typically originate in the urinary tract and ascend to one or both kidneys, often causing additional symptoms like painful urination, a frequent urge to urinate, or cloudy urine.
Spinal infections represent another serious infectious cause, directly affecting the structures of the back. Vertebral osteomyelitis, an infection of the bone in the spine, can cause persistent back pain, though fever may only be present in about 35% to 60% of cases. This condition can also lead to chills, weight loss, and in some instances, neurological changes.
A spinal epidural abscess involves a collection of pus around the spinal cord, often resulting from a bacterial infection. This condition typically causes severe back pain, fever, and chills, and can rapidly lead to neurological deficits such as leg weakness, numbness, or problems with bowel or bladder control due to compression of the spinal cord.
Beyond localized infections, widespread systemic viral illnesses, such as influenza, can also manifest with generalized body aches, including back pain, alongside a high fever. While less common, severe bacterial infections like pneumonia can sometimes cause referred back pain in addition to fever.
Other Serious Causes
Beyond infections, several other serious conditions can present with both back pain and fever. Inflammatory conditions, such as ankylosing spondylitis (AS), are a group of disorders that cause inflammation primarily in the spine. During a flare-up, individuals with AS may experience persistent back pain, often worse in the morning or after inactivity, and can sometimes develop a mild fever.
Abdominal issues can also cause referred pain to the back, sometimes accompanied by fever. Conditions like appendicitis or pancreatitis, while primarily affecting the abdomen, can lead to back pain if the inflammation is severe enough to irritate adjacent nerves or structures. If these conditions progress, they can also trigger a fever.
Although less frequent, certain types of malignancy can present with back pain and fever. Spinal tumors, either originating in the spine or spreading from other parts of the body, can cause persistent back pain that often worsens at night and is not relieved by rest. In some instances, these tumors can also lead to unexplained fever, chills, or unintentional weight loss, indicating a more systemic impact.
When to Seek Immediate Medical Care
Seek urgent care if the fever is high or if the back pain is severe and rapidly worsening. The development of new neurological symptoms, such as numbness, tingling, or weakness in the legs, difficulty walking, or any loss of bowel or bladder control, signals a potential emergency.
Additional red flag symptoms that warrant prompt medical evaluation include a stiff neck, a new skin rash, or unexplained weight loss. If the back pain began after a recent injury or surgery, or if the individual has a compromised immune system due to medication or a chronic illness, medical consultation should not be delayed. Pain that does not improve with rest, or pain that significantly worsens at night, also requires professional assessment.
Diagnosis and Management
When seeking medical help for back pain with fever, the diagnostic process typically begins with a thorough medical history and a physical examination. Healthcare providers will inquire about the nature of the pain, its onset, and any accompanying symptoms.
To identify the underlying issue, various tests may be ordered. Blood tests can detect signs of infection or inflammation. Urine tests are often performed to check for kidney or urinary tract infections. Imaging studies, such as X-rays, MRI (magnetic resonance imaging), or CT (computed tomography) scans, provide detailed views of the spinal structures and surrounding tissues.
Treatment for back pain with fever is entirely dependent on the specific diagnosis. For bacterial infections, antibiotics are typically prescribed. Pain management strategies may include anti-inflammatory medications. In more severe cases, such as spinal epidural abscesses or certain tumors, surgical intervention might be necessary to drain an abscess or remove a growth. Self-treatment is not advised for this combination of symptoms.