What Is A Red Flag When Assessing Back Pain?
In Physical Therapy, we use the term “red flags” to determine a potentially serious symptom of back pain that can indicate a dangerous underlying cause. If a red flag is present during an examination, patients are usually referred to medical specialists for immediate thorough assessment and treatment. When examining the lumbar spine (lower back) there are many red flags to look out for, these symptoms include:
- Previous history of malignancy (Cancer): A history of cancer and also family history of cancer should be established, particularly a close relative, such as a parent or siblings. The most common forms of metastatic cancer are: breast, lung and prostate.
- Unexplained weight loss (Cancer or other metabolic disease): A weight loss of of 5% or more over a 4 week period is a rough indicator of when unexplained weight loss should cause alarm.
- Recent infection
- Saddle anaesthesia (numbness when wiping bottom) (Cauda Equina)
- Progressive spinal deformity: Deformity of the spine with an associated muscle spasm and/or severe limitation of movement are suggested to be key indicators of serious spinal pathology.
- Urinary and faecal incontinence (Cauda Equina)
- Bilateral leg pain (Cauda Equina)
- Hyper-reflexia (Spinal cord compression)
- Erectile Dysfunction (Cauda Equina)
- Traumatic event (Fracture)
- Night sweats and fever (infection)