Stop and get medical help
If you get chest pain or pressure, feel faint or dizzy, are unusually breathless, or your heart races or beats irregularly during exercise, as our plans advise. The American Heart Association says these need immediate medical evaluation.
Source 24
Call 999 (911 in the US)
For chest pain that comes on suddenly and doesn't go away, or spreads to your arms, neck, jaw, stomach or back; a sudden, extremely painful headache while straining; someone who faints while exercising; or palpitations that don't go away, or come with chest pain, breathlessness or feeling faint. Don't drive yourself to A&E.
Sources 25, 26, 27, 28, 29
Call 999 or go to A&E: your back and both legs
Loss of feeling or numbness around the genitals or bottom, new trouble peeing or controlling your bladder or bowels, changes in genital sensation during sex or problems with erections or orgasm, or pain, tingling, weakness or numbness in both legs. These are signs of cauda equina syndrome, which needs treating in hospital urgently. Don't drive yourself. Back pain with chest pain, or after a serious accident, is also a 999 call.
Sources 14, 15, 30
Urgent GP appointment or NHS 111
Back pain and you feel hot, cold, shivery or generally unwell, or severe pain that starts suddenly or is getting worse quickly. In the US, use urgent care.
Source 14
Same day
Leg weakness that is getting worse, or new difficulty lifting the front of your foot or toes, or a foot that slaps down or catches as you walk, as our herniated disc guide says.
See a GP
Sciatica that hasn't improved after a few weeks, is getting worse or is stopping your normal activities; or back pain that doesn't improve after a few weeks of looking after it, is worse at night or when you sneeze, cough or poo, or comes with weight loss, a lump or a change in your back's shape.
Sources 15, 14
Signs of a spinal fracture
Unexplained back pain with muscle spasms, loss of height, or a curved spine or change in posture can be a spinal fracture from osteoporosis, more likely with older age or long-term steroid tablets: see a GP, as our back pain guide says, and stop loaded forward bending.
Sudden eye pain
Intense eye pain, a red eye, rainbow circles around lights, blurred vision, or a headache with feeling sick can be glaucoma that has come on suddenly: call 999 or go to A&E, as our breathing guide says.
Dizzy when you come up
Stop and sit down. See a GP if dizziness won't go away or keeps coming back, or comes with fainting, hearing changes, double or blurred vision, or numbness or weakness, and after any faint.
Sources 23, 28
Check before you start
If you haven't exercised for some time or have a medical condition, speak to your GP first, as the NHS advises. Get advice before hard straining work if your blood pressure is uncontrolled, or you have heart disease or chest pain when you're active, a pacemaker or defibrillator, diabetic eye disease, glaucoma, a hernia, recent eye or tummy surgery, or you're pregnant, as our breathing guide lists.
Source 31
A new lump or bulge
See a GP if you think you have a hernia. Get help from NHS 111 if you have a hernia and pain in or around it, a bloated tummy, sickness, vomiting blood or vomit that looks like coffee grounds, constipation, a high temperature or sudden confusion. Call 999 or go to A&E for a femoral hernia (a lump at the top of the thigh) with very bad tummy pain, sickness, being unable to fart or poo, a high temperature or sudden confusion.
Sources 32, 33