Table 2 Observation protocol for PTs’ assessment of red and yellow flags
Definition of red flags | Examples of PTs’ questions to assess red flags |
|---|---|
Trauma | Have you experienced any trauma related to your pain? |
Severe diagnosis | Have you had cancer or any other severe diagnosis? |
Severe spinal pathology | Have you experienced radiating leg pain? |
Patterns or symptoms not related to mechanical pain | How is your health in general? |
Numbness and paresthesia in the perianal region | Have you had any bowel and bladder disorders? |
Difficulty with micturition | |
Weakness or numbness in the legs related to back pain | Have you felt any weakness or numbness in your legs? |
Definition of yellow flags | Examples of PTs’ questions to assess yellow flags |
Beliefs, appraisal, and judgments | |
Unhelpful beliefs about pain | What are your thoughts about the pain? |
Expectations of poor treatment outcome | What are your thoughts about recovery? |
What do you think about your capability to work? | |
Which factors do you think affect your pain? | |
Emotional responses | |
Distress not meeting the criteria for diagnosis of mental disorder | Are you worried about your pain? |
How does the pain affect your mood? | |
Worry, fears and anxiety | Are you distressed about the pain? |
Are you avoiding doing any activities due to pain? | |
Pain behavior and coping strategies | |
Avoidance of activities due to expectations of pain and possible re-injury | Do you avoid activities due to pain? |
What are you doing when having pain? | |
Over-reliance on passive treatments | What are your thoughts about pain relief? |
What activities are difficult for you due to pain? | |