Back Pain Red Flags

• Younger than 20 or older than 55 and getting back pain for the first time.
• Back pain after a violent injury, e.g. road traffic accident.
• Back pain is constant and getting worse.
• Back pain is in the upper part of the spine.
• Back pain and cancer in the past or at present.
• Back pain and taking (Cortico)steroids.
• Back pain and drug abuser, or HIV infected.
• Back pain and generally unwell or feverish.
• Back pain with significant weight loss.
• Back pain and continuing to have great difficulty bending forwards.
• Nerve related problems other than pain: loss of sensation (especially of the area that would sit on a saddle - so called saddle anaesthesia), loss of power, urinary or bowel incontinence.
• Back pain with obvious structural deformity of the spine.
• Debilitating back pain that is not reducing after 4 -6 weeks.