With most back injuries, it's tough to determine without some type of scan (X-Ray, MRI or CT) to really know for sure. This is because severe muscle spasms cause enough pain that they can be mistaken for disk herniations or fractures. The reason that you need scans to verify it is that spasms always accompany disk herniations or other spinal injury.
Having said that, I can honestly tell you that if your back is seriously injured, you'll know without a doubt. Assuming you can even walk or stand, the pain will be so great that you'll need medical attention to deal with it. Never ask for pain medication though - tell them your pain level, the type of pain (burning, throbbing, stabbing, etc.), and let them determine the problem. If you ask for painkillers straight up, they'll likely not take your pain seriously, thinking instead you're just a drug seeker.
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if there is great pain or the injury results to bleeding,headache or you see a great nerve damge in your skin (giant purple of black spots)