A proverb meaning that when faced with pressing needs, one must accept small sacrifices; you can't avoid necessary losses to deal with a more urgent problem.
車の故障で急に入院費が必要になった。背に腹は変えられないので貯金を切り崩した。
The car broke down and hospital bills suddenly became necessary. I had to dip into my savings — desperate times call for desperate measures.
経営が苦しいときは人員整理もやむを得ない。背に腹は変えられない。
When the business is struggling, layoffs may be unavoidable—desperate times call for desperate measures.