Are you having back pain with any of the following?

  • Severe pain, weakness or tingling in your leg(s).
  • Difficulty stopping urination or loss of control of bladder or bowels.
  • Unexplained fever, nausea or vomiting.
  • A history of cancer or unexplained weight loss.

We understand that you are experiencing one or more of the health issues that might be impacting your back pain.

We recommend that you discuss these health issues with your doctor before proceeding with this program.

Once you are cleared by your doctor to do this program, we hope it helps you find relief from your back pain.

Fainting (Syncope)

Overview

Fainting (syncope) means you suddenly and briefly pass out (lose consciousness). Most people fully recover within a few minutes. About one-third of all people faint at some point in life.

Just before or after fainting, you might:

  • Feel lightheaded and confused.
  • Hear sounds as if they’re far away.
  • Lose muscle tone and fall down.

Fainting is most often caused by reduced blood flow to the brain, such as when blood pressure suddenly drops. Other causes include:

  • Loss of fluids (dehydration)
  • Too warm (overheated)
  • Exhaustion
  • Grief
  • Stress
  • Illness

Fainting can be:

  • Heart-related (cardiac), which may be a sign of heart or circulation problems.
  • Noncardiac, which is more common and rarely dangerous. 

Call your doctor right away if you faint, especially if it’s the first time.

Noncardiac Syncope

Most fainting isn’t dangerous or related to heart problems.

Vasovagal syncope is a common type of fainting. Something triggers the nerve (vagus) that connects your brain and abdomen. This causes your:

  • Heart rate to slow.
  • Blood vessels in the legs to expand.
  • Blood to pool in the lower part of your body.
  • Overall blood flow to the brain to decrease.

Orthostatic (postural) syncope is a type of fainting that happens when your blood pressure suddenly drops. Common triggers are:

  • Sudden standing after sitting or lying down (especially after eating), or standing for too long.
  • Pressure from tight-fitting clothes or a bowel movement.
  • Emotional stress or response, such as to severe pain or the sight of blood.
  • Dehydration.
  • Caffeine, alcohol, and drug use.
  • Medicine that affects blood pressure.

Other common causes of fainting can be serious. Call your doctor if you faint.

Cardiac Syncope

Cardiac syncope occurs when the heart has trouble pumping blood to the brain. Warning signs include:

  • Tightness in the chest
  • Irregular heartbeats
  • Feel fluttering in the heart
  • Strong, pounding heartbeats
  • Shortness of breath

This type of fainting can be a sign of:

  • Heart damage
  • Valve disease
  • A blood clot
  • Problem with the heart’s electrical system 

It’s more likely to happen in older people. Younger people rarely faint from a heart problem. If they do, their condition may be due to a congenital disorder of the heart.

Other causes of cardiac fainting can be:

  • Rapid blood loss.
  • Clogged blood vessel that leads to the brain, which is a rare but serious cause of fainting.

Even if you don’t remember having symptoms before fainting, you may still have a heart condition. Contact your doctor right away if you faint.

Symptoms

You may have symptoms just before fainting, such as:

  • Lightheadedness, dizziness, or confusion
  • Nausea
  • Feel hot, sweaty, or weak
  • Pale skin
  • Tunnel vision or “seeing stars”
  • Tunnel hearing (sounds are far away)

Seek immediate medical care if you faint and:

  • Have a history of heart problems, diabetes, or are pregnant.
  • Fall and are injured or bleeding.
  • Aren’t alert within a few minutes.
  • Have chest pain, pressure, or discomfort.
  • Have a pounding heart, irregular heartbeat, or shortness of breath.
  • Experience loss of speech or vision.
  • Are not able to move or lift things.

If you aren’t sure if it’s serious, contact the advice nurse or your regular doctor.

Diagnosis

We’ll ask you about your medical history and what happened in the days before you fainted. We’ll also give you a physical exam.

We may monitor you in the hospital if we suspect a serious cause. We’ll also order medical tests, such as:

  • Routine blood tests.
  • Electrocardiogram (EKG) of the heart.
  • An ultrasound to check the heart valves (echocardiogram).
  • Heart monitoring (telemetry).
  • Lab tests to rule out low blood levels, heart attack, or electrolyte abnormalities.
  • Vital sign monitoring overnight.
  • Heart rate and blood pressure monitoring when standing, sitting, and lying down.

While fainting doesn’t usually indicate a serious problem, we want to rule out any serious underlying condition.

Treatment

Once we know the cause of fainting, we’ll recommend appropriate treatment. Some causes are easier to treat than others. We may:

  • Ask you to drink more fluids.
  • Monitor your blood sugar levels.
  • Prescribe medicine (such as beta blockers).
  • Change your medications.

If you’re an older adult with recurrent fainting triggered by the vagus nerve, we may recommend that you:

  • Change positions more slowly, such as take 5 minutes to stand up.
  • Wear special socks (TED hose). The socks improve blood flow to your brain when you change positions.

Cardiac Syncope Treatment

When fainting is related to heart problems, we’ll recommend treatment for the specific condition.

For example, if your heart beats too slowly (bradycardia) we may:

  • Adjust your medications.
  • Place a device that continuously monitors your heart’s rhythm (pacemaker).

A pacemaker may be an option if your condition doesn’t improve with medication. If your heartbeat drops below a certain number of beats per minute, the pacemaker delivers an electrical pulse.

If your heart beats too rapidly (tachycardia), we may recommend:

  • Medication to control irregular heartbeat or underlying disease.
  • Placement of flexible, thin tubes through blood vessels and into the heart. We use a special heat to destroy tiny areas of tissue that send abnormal signals to the heart (catheter ablation).
  • A controlled electric shock that restores the heart’s normal rhythm (cardioversion).
  • The placement of a device that continuously monitors the heart, similar to a pacemaker. It delivers a life-saving shock when needed (cardioverter defibrillator).

Caring for Someone Who Faints

It can be frightening when someone near you faints. Keep in mind they usually quickly recover.

First, immediately:

  • Check to see if they’re breathing.
  • Make sure their airway remains open.
  • Call 911 if they’re not breathing. Begin CPR and rescue breathing.

If the person awakens within 2 to 3 minutes, keep them resting for at least 10 to 15 minutes. Help them to lie down in a cool, quiet place. Or help them sit in a chair with their head between their knees.

Also help the person:

  • Loosen tight clothing, especially at the neck.
  • Raise the feet higher than the heart.
  • Turn the head to one side, if vomiting.

When to Call Us

Seek immediate medical care if you faint and:

  • Have a history of a heart problem.
  • Have fallen and are injured or bleeding.
  • Are pregnant.
  • Don’t quickly become alert within a few minutes.
  • Are diabetic.

Also seek urgent care if you faint and:

  • Have chest pain, pressure, or discomfort.
  • Have shortness of breath.
  • Have a pounding heart or irregular heartbeat.
  • Experience loss of speech or vision.
  • Lose the ability to move or lift things. 

Let us know when you faint, especially for the first time, so we can determine if you need further testing.

Additional References:

Related Health Tools:

Prepare for Your Procedure

If you have an emergency medical condition, call 911 or go to the nearest hospital. An emergency medical condition is any of the following: (1) a medical condition that manifests itself by acute symptoms of sufficient severity (including severe pain) such that you could reasonably expect the absence of immediate medical attention to result in serious jeopardy to your health or body functions or organs; (2) active labor when there isn't enough time for safe transfer to a Plan hospital (or designated hospital) before delivery, or if transfer poses a threat to your (or your unborn child's) health and safety, or (3) a mental disorder that manifests itself by acute symptoms of sufficient severity such that either you are an immediate danger to yourself or others, or you are not immediately able to provide for, or use, food, shelter, or clothing, due to the mental disorder.

This information is not intended to diagnose health problems or to take the place of specific medical advice or care you receive from your physician or other health care professional. If you have persistent health problems, or if you have additional questions, please consult with your doctor. If you have questions or need more information about your medication, please speak to your pharmacist. Kaiser Permanente does not endorse the medications or products mentioned. Any trade names listed are for easy identification only.