How Much Back Pain Is Too Much?

Some back pain is normal and fades on its own; certain signs mean you should get checked soon, or go to the ER now.

Baltimore Chiropractor · October 13, 2026

Back pain is too much when it keeps you from normal life, does not improve after a couple of weeks, keeps getting worse, or comes with certain warning signs such as numbness in the groin, new weakness in a leg, fever, or loss of bladder or bowel control. Those warning signs need emergency care. Most other back pain is not dangerous, but pain that lingers is still worth having examined.

Pain level alone is a poor guide. A muscle spasm can feel like a 9 out of 10 and still clear up in days. A dull ache that never leaves can matter more. So look at the pattern, not just the number.

Go to the ER now if you have any of these

These signs are rare, but they can point to a serious problem with the spinal nerves, an infection, or another urgent condition. Do not wait for an appointment.

• Loss of control of your bladder or bowels, or trouble starting to urinate.
• Numbness in the groin, inner thighs, or buttocks (the area that would touch a saddle).
• Sudden or fast-growing weakness in one or both legs, or a foot that drags.
• Back pain with fever or chills, especially if you feel generally ill.
• Severe pain after a major fall or crash, or any back pain with a known or suspected broken bone.
• Chest pain, trouble breathing, or sudden tearing pain in the back or abdomen.

If you were just in a car accident and have any of these, call 911 or go to the ER first. Chiropractic care comes after serious injury has been ruled out.

Book a visit soon if you notice these

These signs are not emergencies, but they are good reasons to be seen within days rather than weeks.

• Pain that has lasted more than two weeks without clear improvement.
• Pain that shoots down one leg, especially below the knee, or causes tingling or numbness in the leg or foot.
• Pain that wakes you at night or is just as bad lying still as when you move.
• Pain that started after a car accident, even a minor one. Soreness can show up a day or more after a crash.
• Neck pain with headaches, arm tingling, or trouble turning your head.
• Pain that keeps coming back every few weeks.
• Pain that is changing how you walk, sleep, work, or lift your kids.

Normal back pain: what it usually looks like

Most episodes of low back pain are linked to strained muscles, stiff joints, or irritated discs. They often start after lifting, twisting, a long drive, or a long day at a desk. The National Institute of Neurological Disorders and Stroke notes that acute low back pain often improves within a few weeks, and many people recover without needing surgery.

Typical signs of ordinary back pain:

• It feels worse with certain movements and better with others.
• It is a stiff, achy, or tight feeling in the muscles near the spine.
• It slowly improves each day, even if it is slow.
• You can still do most daily tasks, with some care.

What to try at home first

If you have no warning signs, a few simple steps are reasonable for the first week or two.

1. Keep moving. Short walks beat bed rest. Long rest tends to make a stiff back stiffer.
2. Change position often. Do not sit for more than 30 to 45 minutes at a time. Stand, walk, and reset your posture.
3. Use heat or ice. Either one can ease the pain for a short time. Use whichever feels better, for about 15 to 20 minutes, with a cloth between your skin and the pack.
4. Sleep with support. On your side, put a pillow between your knees. On your back, put a pillow under your knees.
5. Avoid heavy lifting and deep twisting until the sharp pain calms down. Then add activity back slowly.
6. Ask your pharmacist or doctor about over-the-counter pain relievers. Follow the label, and check first if you have stomach, kidney, or heart conditions or take blood thinners.

Common mistakes that make back pain last longer

• Resting too much. A day or two of taking it easy is fine. Weeks of avoiding movement usually backfire.
• Pushing through sharp pain. Gentle discomfort while moving is one thing. Sharp or electric pain, or pain that spreads down a leg, is a sign to stop.
• Ignoring pain after a crash. Adrenaline can hide an injury for hours or days. Whiplash and back sprains often show up late.
• Waiting months to be seen. The longer pain goes on, the harder it can be to pin down what is driving it.
• Guessing at the cause. Sciatica, a disc problem, a muscle strain, and joint irritation can feel alike but need different approaches.

What a visit to a chiropractor looks like

A good first visit starts with questions. When did the pain begin? What makes it better or worse? Did anything happen, such as a lift, a fall, or a car accident? Do you have numbness, weakness, or other symptoms?

Next comes a physical exam. This usually includes checking how you move, testing strength, reflexes, and sensation, and feeling the muscles and joints of the spine. If the exam suggests something that needs imaging, medical testing, or a different kind of doctor, a responsible chiropractor will tell you and refer you.

If the exam shows a problem that fits chiropractic care, the plan may include spinal adjustments, soft tissue work, and home exercises. You should leave the visit knowing what is likely going on, what the plan is, and what to expect over the coming weeks.

Back pain after a car accident

Car accident injuries deserve special care. Even a low-speed crash can strain the muscles, ligaments, and joints in the neck and back. Pain may start the next day or later. If you were in a crash and your back or neck hurts, get checked even if the pain seems mild. Write down when it started and what you feel, because clear notes help with both your care and any insurance claim.

In Maryland, Personal Injury Protection (PIP) coverage on many auto policies can help pay medical bills after a crash, no matter who was at fault. Your coverage depends on your own policy, so check with your insurer about what applies to you.

A simple rule to remember

Use this quick check:

• Red-flag signs? Go to the ER now.
• No improvement after about two weeks, leg symptoms, night pain, or a recent accident? Get examined.
• Mild and getting better? Keep moving, use the home steps above, and watch it for a few days.

If you are unsure which group you are in, it is fine to ask. A short exam is a better way to find out than waiting and worrying.

Sources: National Institute of Neurological Disorders and Stroke (NINDS).