If your back pain symptoms get worse or don’t improve within a few days after a fall, your doctor can help identify underlying causes like muscle strain or disc herniation.

Falling can hurt. It’s natural to tense up, moving your limbs and torso in unexpected ways as you try to save yourself. These random movements, combined with the impact of hitting the ground, can spell disaster for your back.

You don’t have to be advanced in age to experience a debilitating fall. Approximately 800,000 people are hospitalized annually for falls in the United States alone, and globally falls are the second leading cause of unintentional injury death.

If you’ve fallen and are experiencing back pain, your doctor can verify if your symptoms are from a mechanical back injury or an unrelated condition.

Falling on your back can cause a wide variety of symptoms.

Your back is made up of multiple bones, nerves, connective tissues, and muscles that can all cause pain. How you fall, where you fall, and your overall health and age can also be influential.

In general, if you’ve fallen on your back, symptoms that require an immediate emergency room visit include:

  • bowel or bladder symptoms
  • numbness or weakness
  • excruciating pain not responsive to over-the-counter medication
  • gait imbalance
  • instability
  • mental status changes, loss of vision
  • any accident that involved a fall from a high height, car, bike, or motorcycle

Other symptoms to look out for include:

  • new tenderness, soreness, or pain
  • pain that worsens with lifting, bending, or hinging motions
  • radiating pain from the back into your extremities
  • pain that keeps you up at night
  • symptoms that worsen after sleeping but improve with movement
  • increased pain when standing or sitting
  • pain that feels like burning, pulsing, or electricity
  • sexual function changes
  • pain that comes and goes

Delayed injury back pain symptoms

Back pain after a fall doesn’t always appear immediately.

It can take time for inflammation to set in, and depending on the nature of your fall, in-the-moment endorphins can temporarily block the intensity of pain signals going to your brain.

Days later, after endorphins wear off and your body’s inflammatory process is underway, pain and stiffness can appear seemingly out of nowhere.

It’s also possible to experience a latent injury from a fall. Latent injuries are those that worsen in the weeks or months after an injury when bleeding, inflammation, or other tissue trauma accumulates enough to cause symptoms.

Falling on your back typically causes mechanical back pain, pain related to injuring the anatomy of your skeleton, muscles, nerves, and other tissues.

Most mechanical back pain affects the lower back. It includes injuries such as:

How to tell if your back pain is muscular

It’s not always easy to tell if your back pain is primarily soft tissue-related or skeletal. Many people experience varying types of pain because of how the structures of the back are interconnected.

In general, skeletal pain is intense, feels “deep,” and remains localized. It can become sharper with specific movements.

Muscle pain can also be localized depending on the severity of your injury, but muscle pain can feel more widespread, aching, and sometimes improves with movement after muscles warm up.

Shooting, burning, radiating, or electrifying pain may be related to nerve injury, which can occur with both muscle and skeletal back injuries.

It’s tempting to try to pop back up after a fall on your back like nothing happened, but this might not be the best option.

If you’ve fallen on your back, you can help prevent further injury by:

  • lying still for a few minutes to assess how your body feels
  • rolling gently and slowly onto your side (if possible), taking a moment to assess how you feel in this position
  • transitioning to your hands and knees and crawling to a stable wall or other support
  • rising slowly from your knees, one foot at a time
  • slowly maneuvering to a chair and sitting, once again assessing how you feel

If you’re in pain immediately after your fall and don’t think you can get up, try:

  • yelling for assistance
  • sliding to a phone, window, or door where you can call out
  • banging an object to alert those around you
  • focusing on staying warm and comfortable until someone arrives to help

Should you treat your own back immediately after a fall?

Not all treatments at home are appropriate for all back injuries. Using cold compresses when you should use warm ones, for example, may make your pain worse.

Speaking with your doctor first, even just over the phone, can help you know which pain medications, compresses, sleeping positions, and movements to avoid/prioritize at home.

It’s recommended you see a doctor anytime you have back pain after a fall. Everyone’s pain perception is unique, and what might be mild pain to you could still be a sign of a serious injury.

Talk with your doctor immediately if your back pain isn’t helped with medication or is accompanied by any of the following:

If you don’t feel the need to see your doctor right away, consider making an appointment if back pain doesn’t improve within a few days or completely resolves by 6 weeks. A workup generally entails a physical exam, X-ray, and possibly a CT or MRI.

Knowing when you should worry about back pain after a fall isn’t always easy. You might not experience symptoms right away, or you may assume mild back pain means there’s nothing to be concerned about.

Because you have no way of knowing at home how severe a back injury is, speaking with your doctor anytime you have back pain after a fall is recommended.