Treatment guidelines published around the world note that ruling out “red flags” is a healthcare provider’s number one responsibility, which is in line with the decree exhorted by all healthcare professionals when first entering practice to do no harm. When detected, red flags prompt a doctor to stop and immediately send the patient to the appropriate healthcare provider or emergency department to avoid a catastrophic outcome, which may include death.
The four main red flags cited for low back pain include: cancer, fracture, cauda equine syndrome, and infection. In 1992, Dr. Richard Deyo reported that the patient’s history is more important for identifying red flags than a routine physical exam, especially in the early stages of these conditions. This is partially why new patients need to fill out so much paperwork on their initial visit. These are the factors that suggest red flags when it comes to low back pain:
Cancer: a past history of cancer, unexplained weight loss, failure to improve with a month of therapy, no relief with bed rest, and duration of pain over one month. However, when the combination of age over 50 years, past history of cancer, unexplained weight loss, and failure to improve with one month of therapy exists, the sensitivity or “true-positive” reaches 100%—in other words, IT IS CANCER until proven otherwise!
Cauda equine syndrome: acute onset of urinary retention or overflow incontinence, loss of anal sphincter tone or fecal incontinence, “saddle” anesthesia, and global or progressive motor weakness in the lower limbs.
Infection: prolonged use of corticosteroids (such as organ transplant recipients); intravenous drug use; urinary tract, respiratory tract, or other infection; and immunosuppressant medication and/or condition.
Spinal fracture: history of significant trauma at any age; minor trauma in persons over 50 years of age; patient over 70 years of age with a history of osteoporosis (with or without trauma); and prolonged use of corticosteroids. A checklist that includes these important historical questions can be easily applied in any practice, which is highly recommended.
All healthcare providers—including chiropractors—managing patients in a primary care setting are obligated to rule out red flags in order to ensure patient safely when rendering treatment for LBP. The good news is that most cases of low back pain aren’t caused by these red flags and respond well to conservative chiropractic care!
You may wonder, “Do I need an MRI scan of my back.”
Also, if you feel leg pain it may indicate things are getting worse and may indicate a bulge on the disc or worse yet a herniated disc in your back. Some people will try stretching the lower back first to see if they get relief from their back pain. Pain very low in the lower back may be originating from the coccyx or tailbone. A pulled muscle in the back generally will get better with rest. Persistent or worsening pain intensity and/or frequency necessitates a visit to see a professional.
Call me, Dr. Tim Harcourt, at (239) 278-3344 or stop by on your day off for a walk in visit and mention this article for an awesome discounted first visit to include history, exam, and adjustment or Class IV high-intensity laser treatment. So if you find yourself experiencing lower back pain while running or doing physical activities.
If you are suffering from back pain that is affecting your quality of life and allowing you to enjoy Fort Myers Beach. Come see us at Coast Chiropractic Centers located on 7270 College Parkway.
If you would like to avoid getting back pain in the first place or to take a proactive approach to your health and wellness, our membership program called Club C may be just the thing for you with great cost savings, convenience, and even more importantly, a plan to get your health back and keep it.
Don't let back pain stop you from enjoying the beautiful SWFL! Dr. Tim Harcourt is here to give you the relief you need.
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