Red Flag Symptoms

‘Red flags’ is a term used to describe symptoms or signs that may suggest serious pathology. In back pain red flags may indicate spinal fracture, spinal malignancy, spinal infection or cauda equine syndrome.

Red flag symptoms are:

• Onset at age <20 or >55
• Non mechanical pain – indicates a cause for back pain other than musculoskeletal
• Thoracic pain – could be due to a thoracic aortic aneurysm
• Previous history of HIV infection – have a higher risk for infections that may arise within the spine
• Weight loss – a constitutional symptom that raises the possibility of an underlying malignancy
• Weight gain – unlikely to suggest active malignancy
• Widespread neurological symptoms especially sphincter disturbance
• Structural spinal deformity
• Feeling generally unwell – consider underlying infection or malignancy