Table 1 Red flag conditions indicating possible underlying spinal pathology or nerve root problems that will be recorded.
Red flag | Possible underlying pathology |
|---|---|
Previous history of cancer | Cancer |
Age at unset < 20 or > 55 years | Cancer |
Unexplained weight loss | Cancer |
Pain at rest | Cancer |
Non-mechanical pain | Cancer, vertebral infection |
Systematically unwell | Cancer, vertebral infection |
Increased C-reactive protein level | Cancer, vertebral infection |
Fever | Vertebral infection |
Urine tract infection or skin infection | Vertebral infection |
Recent bacterial infection e.g. urinary tract or skin infection | Vertebral infection |
Age > 70 years | Fracture |
Trauma as cause of the back complaint | Fracture |
Sudden decrease in height | Fracture |
History of osteoporosis | Fracture |
Urinary retention | Cauda equina syndrome |
Acute onset of urinary retention or incontinence | Cauda equina syndrome |
Morning stiffness | Inflammatory disorder |
Pain improves with physical activity | Inflammatory disorder |
Pain in the leg worse than back pain | Lumbosacral radicular syndrome |