Red flags:
- are indicators of serious spinal pathology:
- age of onset less than 20 years or more than 55 years,
- recent history of violent trauma;
- constant progressive, nonmechanical pain (no relief with bed rest);
- thoracic pain;
- past medical history of malignant tumor;
- prolonged use of corticosteroids;
- drug abuse,
- immunosuppression, HIV;
- systemically unwell;
- unexplained weight loss;
- widespread neurological symptoms (including cauda equine syndrome);
- Saddle anesthesia
- bowel or bladder dysfunction,
- spinal deformity
- fever.
Yellow flags
- are psychosocial factors indicative of long-term chronicity and disability:
- a negative attitude that back pain is harmful or potentially severely disabling;
- fear avoidance behavior and reduced activity levels;
- an expectation that passive, rather than active, treatment will be beneficial;
- a tendency to depression, low morale, and social withdrawal;
- social or financial problems.
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