Red flags/ contraindications

Question 1

Lumbar/ pelvic red flags?

Answer 1

Bladder/ bowel dysfunction
Saddle anaesthesia
Bilateral paraesthesia/ numbness
Bilateral leg pain
Lower limb weakness

Question 2

Thoracic/ Cervical red flags?

Answer 2

Bilateral paraesthesia
Gait disturbance/ lower limb weakness
Clumsiness
5Ds/3Ns:
- dizziness
- diplopia
- drop attacks
- dysphagia
- dysphasia
- nausea
- numbness (facial)
- nystagmus

Question 3

Exercise contraindications?

Answer 3

• Acute severe flare of arthritic joint or infection
o Myelopathy or cauda equina syndrome
o Acute or unstable fracture
o Systemic unwell – e.g active cancer, sepsis

Question 4

Manual therapy contraindications?

Answer 4

o Joint instability (acute or unstable fracture, infection)
o Local cancer
o Open wound
o Rheumatoid arthritis (cervical spine)
o Cauda equina syndrome
o Upper motor neurone signs / myelopathy
o Vertebral arterial insufficiency