Pain that fails to relieve predictably with rest (“night pain”) and associated constitutional symptoms (fever, chills, unintended weight loss) are always red flags for further investigation to avoid delays in making important diagnoses, such as malignancy or infection.
The classic cardinal signs of cervical ischemia, colloquially referred to as the '5Ds and 3 Ns,' also present in the late stage of CAD: diplopia, dizziness, drop attacks, dysarthria, dysphagia, ataxia, nausea, numbness, and nystagmus [19,20].
The red flags used most commonly for identifying spinal cord compression, irrespective of the etiology, are profound motor or sensory weakness in the lower extremities, bowel or bladder dysfunction, and saddle distribution sensory disturbance (16).
“Red flag” and “yellow flag” signs
Red flags are possible indicators of serious spinal pathology: Thoracic pain. Fever and unexplained weight loss. Bladder or bowel dysfunction.
The presence of a "red flag" should alert clinicians to the need for further examination and, in most cases, specific management. With respect to vertebral fractures, the typical “red flags” include >50 years of age, prolonged corticosteroid use, trauma, and Osteoporosis.
“Red flags” include pain that lasts more than 6 weeks; pain in persons younger than 18 years or older than 50 years; pain that radiates below the knee; a history of major trauma; constitutional symptoms; atypical pain (eg, that which occurs at night or that is unrelenting); the presence of a severe or rapidly ...
Steroids: Using steroids or intravenous drugs puts one at greater risk for back infections and particularly spinal epidural abscesses. History: If you have a history of cancer, HIV or tuberculosis, back pain can mean a serious complication or recurrence. Get treatment immediately.
Sometimes, medical conditions like a slipped disc, sciatica (a trapped nerve) or ankylosing spondylitis can cause back pain. Very rarely, back pain can be a sign of a serious problem such as a broken bone, cancer or an infection.
Double red flags means water is closed to the public. Red flag is high hazard meaning high surf and/or strong currents.
What are major red flags? Some red flags can be sorted out with conversation and therapy. However, some should never be tolerated. Major red flags are infidelity, gaslighting, controlling behavior, angry outbursts, and physical, sexual, or emotional abuse.
Back pain red flags – Night Pain
Back pain that worsens at night or while you're sleeping might indicate something more severe like an infection or cancer. This is especially true if you also have other symptoms in addition to your back discomfort when you sleep or relax.
Cauda equina red flag signs include bladder dysfunction, bowel dysfunction, pain and/or altered sensation in the legs, loss of sexual sensation, and saddle numbness. It is vital to seek advice immediately from a medical professional if you notice any of these warning signs.
Change in balance or coordination. Numbness or tingling in the arms or legs. Decrease in movement of the arms or legs. Injury to the head, neck, or back.
Sharp pain rather than a dull ache: This could indicate a torn muscle or ligament, or a problem with an internal organ in the back or side. 2. Radiating pain: This pain "moves" or shoots to the glutes or legs, which could indicate a nerve compression condition. Radiating pain could be a sign of nerve damage.
Some symptoms (often called "red flag" symptoms) may suggest that the back pain has a more serious cause. These include fever, recent trauma, weight loss, a history of cancer and neurological symptoms, such as numbness, weakness or incontinence (involuntary loss of urine or stool).
Bone pain is a “red flag” and is a common feature of leukaemia, metastatic neuroblastoma and primary bone tumours. This may be night pain or constant 'nagging' pain. These malignancies may present with a swollen joint(s) and can mimic arthritis.
Red-flag signs and symptoms of spinal stenosis
Rarely, severe spinal stenosis may cause red-flag symptoms, such as bowel and/or bladder incontinence, numbness in the inner thighs and genital area, and/or severe weakness in both legs.
The bottom line is that not all pain is able to be detected on an x-ray or MRI. That does not mean that there is nothing there that needs to be treated or diagnosed. In fact, it means that it is possibly a precursor to something going really wrong and then eventually needing surgery because it eventually winds up torn.
Medications such as NSAIDs, acetaminophen and muscle relaxants are effective first-line treatments for pain relief in patients with acute lower back pain.
L5 radiculopathy is usually associated with numbness down the side of the leg and into the top of the foot. S1 radiculopathy typically results in numbness down the back of the leg into the outside or bottom of the foot. Weakness is another symptom of nerve root compression.