Low Back Pain Red Flags

Back-Related Tumor Pain Presentation

Constant back pain, pain worst at night

Back-Related Tumor History

Age > 50, prior history of cancer, unexplained weight loss, failure of conservative care

Back-Related Infection Pain Presentation

Constant back pain day and night, increases with activity, progressive pain

Back-Related Infection History

Recent infection, IV drug use, immunosuppressive disorder, recent spinal surgery

Back-Related Infection Exam

Fever, localized spinal tenderness

Cauda Equina Syndrome Pain Presentation

Lumbar spine related disorders (disc herniation, spinal stenosis)

Cauda Equina Syndrome History

History of spinal stenosis or disc herniation, saddle anesthesia, urine retention or incontinence, fecal incontinence

Cauda Equina Syndrome Exam

Progressive lower extremity weakness, sensory deficits in feet

Spinal Fracture Pain Presentation

Midline spine pain, aggravated with lumbar ROM

Spinal Fracture History

Age > 70, trauma, long-term steroid use

Spinal Fracture Exam

Localized edema, increased pain with weight-bearing, exquisite tenderness over fracture site

Abdominal Aortic Aneurysm Pain Presentation

Often asymptomatic before dissection; severe sharp low back and/or abdominal pain

Abdominal Aortic Aneurysm History

Older male (>50), history of smoking, family history of AAA, atherosclerosis

Abdominal Aortic Aneurysm Exam

Widened aortic pulse, pulsating abdominal mass, bruit detected over the aorta