Red Flags

Question 1

Low Back Region

Back-related tumor

Answer 1

• age >50 yrs
• Hx CA
• unexplained weight loss
• failure of conservative therapy
• age > 50 years OR Hx CA OR failure of conservative therapy

Question 2

Low Back Region

Back-related infection (spinal osteomyelitis)

Answer 2

• recent infection (eg urinary tract or skin infection)
• IV drug user/abuser
• concurrent immunosuppressive disorder

Question 3

Low Back Region

Cauda equina syndrome

Answer 3

• urine retention or incontinence
• fecal incontinence
• saddle anesthesia
• global or progressive weakness in the LEs
• sensory deficits in the feet (ie L4, L5, S1 areas)
• ankle DF, toe EXT, and ankle PF weakness

Question 4

Low Back Region

Spinal fracture

Answer 4

• Hx trauma (including minor falls or heavy lifts for individuals with osteoporosis or elderly individuals)
• prolonged use of steroids
• age >70 yrs

Question 5

Cancer

Answer 5

*indicates need for referral to physician

• persistent pain at night
• constant pain anywhere in the body
• unexplained weight loss (eg 4.5-6.8kg / 10-15lbs in 2 wees or less)
• loss of appetite
• unusual lumps or growths
• unwarranted fatigue

Question 6

Cardiovascular

Answer 6

*indicates need for referral to physician

• SOB
• dizziness
• pain or a feeling of heaviness in the chest
• pulsating pain anywhere in the body
• constant and severe pain in lower leg (calf) or arm
• discolored or painful feet
• swelling (no Hx injury)

Question 7

Gastrointestinal / Genitourinary

Answer 7

*indicates need for referral to physician

• frequent or severe abdominal pain
• frequent heartburn or indigestion
• frequent nausea or vomiting
• change in or problems with bladder function (eg urinary tract infection
• unusual menstrual irregularities

Question 8

Micellaneous

Answer 8

*indicates need for referral to physician

• fever or night sweats
• recent severe emotional disturbances
• swelling or redness in any joint with no Hx injury
• pregnancy

Question 9

Neurological

Answer 9

*indicates need for referral to physician

• changes in hearing
• frequent or severe headaches with no Hx injury
• problem with swallowing or changes in speech
• changes in vision (eg blurriness or loss of sight)
• problem with balance, coordination, or falling
• fainting spells (drop attacks)
• sudden weakness