Red flag symptoms: Back pain. Back Pain Red Flags Back pain is a common complaint with approximately 85% of the population experiencing back pain at some point in their lives. ACUTE BACK PAIN PATHWAYRED FLAGS. J Bone Jt Surg. While your initial medical exam may not pinpoint the exact problem, it can lead the way to a timely diagnosis and treatment of issues such as cancer, infection, extreme (and ultra-debilitating) spinal problems and more. Age under 20 or over 50 years when the pain first starts. If you have thoracic spine pain, these are the alarm features to look out for: Recent serious injury, such as a car accident or a fall from a height. The “red flags” of back pain are important historical and physical features that point to potentially dangerous conditions. 2018;100(5):368–74. Red flags are signs and symptoms that are possible indicators of serious spinal pathology.

Due to the lack of robust evidence for many red flags their use has been questioned. Precautions Low back red flags have poor test specificity >80% patients with mechanical low back pain have at least one red flag Evaluate red flags in the context of the clinical presentation as a whole Keep a high index of suspicion in high risk patients or where more than one red flag is present Cancer Age >50yrs or <20yrs with NEW onset pain I am joined in the presentation by Diarmaid Ferguson-title, Phyio champion for the regional pathway and MSK physiotherapy practitioner Northumbria Trust Back pain is common in the UK with a lifetime chance of occurrence of 59 per cent. See a doctor if you have: Low back pain is so common that most of the people assume that it is always related to a muscle strain or to a joint strain. A 40 year old man presents with a two year history of chronic low back pain. The aim was to conduct a systematic review specifically reporting on studies that evaluated the diagnostic accuracy of red flags … 2018;100(5):368–74. Thoracic back pain red flags. The pain follows a violent injury, such as a car accident #### The bottom line A 13 year old boy attends with his mother, complaining of aching lower back pain for two weeks. Show him a diagram or model of the lumbar spine indicating the vertebrae, discs, and nerve roots. Red flags for possible serious spinal pathology include : However, many patients with thoracic back pain have a benign, mechanical cause. sciatica (irritation of the nerve that runs from the lower back to the feet) – this can cause pain, numbness, tingling and weakness in the lower back, buttocks, legs and feet ankylosing spondylitis (swelling of the joints in the spine) – this causes pain and stiffness that's … Red flags that suggest cauda equina syndrome include: Severe or progressive bilateral neurological deficit of the legs, such as major motor weakness with knee extension, ankle eversion, or foot dorsiflexion. Cauda Equina Syndrome – Red flag of back pain. Ferguson F(1), Holdsworth L, Rafferty D. Author information: (1)NHS Quality Improvement Scotland, Glasgow, UK. Many patients with Low Back Pain have at least one red flag (>80%); Evaluate red flags in the context of the clinical presentation as a whole. ... Cauda Equina Syndrome is an orthopaedic emergency clinical scenario, which is characterised by acute back pain, bilateral leg pain and weakness, perianal loss of sensation and bladder (mainly) or bowel (rarer) function disturbances.

The presentation of thoracic back pain will depend on the underlying cause. There is limited evidence or guidance on how red flags should be used in practice. ### History The onset, duration, and nature of the pain will help to differentiate non-specific (that is, unexplained, non-pathological) back pain from potentially serious conditions: Focused questions to illicit “red flags” are essential (box 1). Back pain: Nine red flags you need immediate medical attention for your backache BACK pain is a common condition but usually isn’t the sign of anything serious. We would like to show you a description here but the site won’t allow us. Keep a high index of suspicion in high risk patients or where more than one red flag is present In Press. If you are suffering from lower back pain and notice any of the following red flags, you should make an appointment to see your doctor as soon as possible. 2019. fferguson@nhs.net BACKGROUND: Red flags are recognised as indicators of possible serious spinal pathology, and their use is indicated by numerous guidelines.

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