Red Flags

TUNA FISH

causes of back pain

Structural

Mechanical

Facet joint arthritis

Prolapsed IVD

Spondylolysis / Spinal stenosis

Inflammatory

Sacroiliitis

Spondyloarthropathies

Infection

Osteomyelitis

Metabolic

Osteoperotic Vertebral Collapse

Paget's disease

Osteomalacia

Neoplasm

Cancer

Prostate

Breast

Cauda Equina

Tumour or metastases

Non-mechanical pain

Unexplained weight loss

Neurological symptoms

Bladder/bowel problems

Inability to walk

Foot drop

Saddle paraesthesia

Sexual dysfunction

Age >50 or <20

Immunodeficiency (including IVDU)

Systemically unwell

History of carcinoma

5-30% of systemic cancer patients

Various parts of the spine

Tumours require energy to grow

50 higher risk of malignancy

<20 Unusual presentation for LBP

Fever

Night sweat

Night Pain

Signs of systemically unwell

increased metabolic cost

Non-mechanical back pain

potential sign of serious pathology

Can get to sleep but wakes with pain

Weakened immune system

Infection

Diabetes

IV Drug Use

HIV

General Malaise

reduced capacity to withstand ill health

increased risk of infection

Risk of metastases