Low Back Pain Red Flags

Low Back Pain Red Flags
1. Risk factors for cancer (If all three of these risk factors for cancer are absent, studies suggest that cancer can be ruled out with 100% sensitivity)
[select name="Q1" value="no|YES"] <-- Age 50 years old or older with a history of cancer
[select name="Q2" value="no|YES"] <-- Unexplained weight loss
[select name="Q3" value="no|YES"] <-- Failure to improve after four to six weeks of conservative low back pain therapy
2. Risk factors for possible spinal infection
[select name="Q4" value="no|YES"] <-- Intravenous drug use
[select name="Q5" value="no|YES"] <-- Immunosuppression
[select name="Q6" value="no|YES"] <-- Urinary infection
[select name="Q7" value="no|YES"] <-- Fever above 38°C (100.4°F) for greater than 48 hours
[select name="Q8" value="no|YES"] <-- History of tuberculosis or active tuberculosis
3. Signs or symptoms of Cauda Equina Syndrome
[select name="Q9" value="no|YES"] <-- New onset of urinary incontinence
[select name="Q10" value="no|YES"] <-- Urinary retention (if no urinary retention, the likelihood of Cauda Equina Syndrome is less than 1 in 10,000)
[select name="Q11" value="no|YES"] <-- Saddle anesthesia
[select name="Q12" value="no|YES"] <-- Unilateral or bilateral sciatica
[select name="Q13" value="no|YES"] <-- Sensory and motor deficits
[select name="Q14" value="no|YES"] <-- Abnormal straight leg raising
4. Increased risk factors for fragility fracture
[select name="Q15" value="no|YES"] <-- Osteoporosis
[select name="Q16" value="no|YES"] <-- History of steroid use
[select name="Q17" value="no|YES"] <-- Immunosuppression
[select name="Q18" value="no|YES"] <-- Serious accident or injury (fall from heights, blunt trauma, motor vehicle accident) – does not include twisting or lifting injury unless other risk factors are present (e.g., history of osteoporosis)
[select name="Q19" value="no|YES"] <-- Clinical suspicion of ankylosing spondylitis      [link url="../../musculoskeletal/spondyloarthropathy/" memo="See Spondyloarthropathy Tool"]   
[select name="Q20" value="no|YES"] <-- Drug or alcohol abuse (increased incidence of osteomyelitis, trauma, fracture) 
5. Increased incidence of clinically significant pathology
[select name="Q21" value="no|YES"] <-- Unrelenting night pain or pain at rest
[checkbox memo="display/hide references" name="footnotes" value=""][conditional field="footnotes" condition="(footnotes).is('')"]
reference:  
[link url="//www.icsi.org/guidelines__more/catalog_guidelines_and_more/catalog_guidelines/catalog_musculoskeletal_guidelines/low_back_pain/" memo="#1"] ICSI - Institute for Clinical Systems Improvement
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