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Lower Back Pain - Red Flags

February 23, 2015

Over 80 % of adults will experience lower back pain at some time during their lives. Most of the time it is a musculoskeletal problem. However, it is very important to rule out other causes of lower back pain by asking the right questions.


  • How old is the patient? Pain in those younger than 20 and older than 50 can indicate that non-musculoskeletal issues should be considered.

  • Was there a trauma? Auto-accident, slip and fall, collision in sports. This could indicate a fracture and/or internal damage.

  • Where is the pain? Pain in the lower back with radiating pain down the legs or pain in the kidney or abdominal areas could mean anything from disc issues to a kidney stone.

  • Is there a history of cancer? Any person with a prior history of cancer should be screened for metastasis or spread of the cancer.

  • Is there a history of an immunosuppressive disease – AIDS, HIV?

  • Are there any neurological signs and symptoms like electric shock pain down the legs or change is bladder or bowel function?

  • Is there a history of fevers and/or significant weight loss?

  • Is there more pain when lying down, when at rest, at night?

  • Is the pain rapidly escalating?


If you have any of these signs and symptoms, a complete examination is the prudent thing to have done!

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