Table 1 Visceral or potentially serious or life threatening diseases that can present as spinal pain.
Disorder | Detected by |
|---|---|
Cancer | Previous history of CA, no position of relief, fever, constitutional symptoms, weight loss |
Benign tumor | Localized severe pain, no position of relief, dramatic relief with NSAID, pain on percussion |
Infection | History of fever and/or chills, fever on examination, pinpoint tenderness, redness or heat |
Fracture | History of trauma, history of osteoporosis, pain on percussion |
Seronegative spondyloarthropathy | Hx of iritis, AM stiffness, improvement with exercise, family Hx |
GI disease | GI complaints, relation of pain to certain foods, abdominal examination |
GU disease | GU complaints, bleeding, spotting, unusual discharge, GU examination |
Myelopathy | Gait difficulties, bowel/bladder dysfunction, UMN signs, spasticity, sensory level |
Cauda equina syndrome | Bowel/bladder difficulties, saddle anesthesia, decreased anal sphincter tone |