I had a 50 year old with backpain for a week, one time. He had no good reason for getting this pain. No hard work, no trauma, nothing. Examination was ok. He was going to drive to germany the next day with his wife. I had a bad feeling about him and sent him to the hospital. It turned out he had an anurism deep in his abdomen, and needed emergency surgery the same day. Probably would have died on the long road to germany. Its not good dying when you are on the autobahn in 150km/t. He was grateful I remember.