My wife hurt her back yesterday. We don't have insurance so we're trying to figure out if she really needs to see a doctor. Are there any red flags to point out when medical care is really needed? We definitely can't afford an MRI.

MRIs and even less expensive imaging like X-rays aren't usually advised in the first few weeks following a back injury or back pain. This isn't true if there's any reason to suspect a fracture. In the majority of cases acute back pain patients get better in one to two weeks after the start of pain.

Red flags that suggest the need for medical referral include:

  • Age over 40, especially over 50 years old
  • The presence of constitutional symptoms like fever, chills, sweating, nausea, vomiting along with the back pain
  • A previous history of cancer of any kind
  • Recent history of urinary tract infection
  • Severe pain at night that wakes her up and won't go away no matter what she does

    Other red flags come out as time goes by. For example, failure to get better despite conservative care. Sometimes other symptoms start to develop after a couple of weeks or months that help point to a more serious problem that requires further medical care.

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