Red flags of low back pain (mnemonic)

Last revised by Craig Hacking on 18 Aug 2021

Citation, DOI, disclosures and article data

Citation:

Lustosa L, Hacking C, Botz B, Red flags of low back pain (mnemonic). Reference article, Radiopaedia.org (Accessed on 19 Apr 2024) https://doi.org/10.53347/rID-91058

DOI:

https://doi.org/10.53347/rID-91058

Permalink:

https://radiopaedia.org/articles/91058

rID:

91058

Article created:

9 Jul 2021, Leonardo Lustosa ◉

Disclosures:

At the time the article was created Leonardo Lustosa had no recorded disclosures.

View Leonardo Lustosa's current disclosures

Last revised:

18 Aug 2021, Craig Hacking ◉ ◈

Disclosures:

At the time the article was last revised Craig Hacking had no recorded disclosures.

View Craig Hacking's current disclosures

Revisions:

3 times, by 3 contributors - see full revision history and disclosures

Systems:

Musculoskeletal

Sections:

Mnemonics

Tags:

low back pain, red flags, mnemonic, screening, imaging

Low back pain is a very common condition among primary care patients. Most patients have nonspecific low back pain (85-90%) and would have unremarkable radiographs. The purpose of the red flags is to aid in the recommendation for imaging of the spine. A mnemonic to remember the red flags of low back pain is:

THE RED FLAGS

Mnemonic

T: trauma
H: history of cancer
E: extended duration (>4-6 weeks)
R: rest or night pain
E: equina
D: disability
F: fever
L: losing weight
A: age <20 or >50
G: general symptoms
S: steroid use or immunosuppression

Equina refers to cauda equina syndrome (CES). Signs and symptoms of CES include: saddle anesthesia, bladder and sphincter dysfunction, progressive motor and sensory deficit in lower limbs, sciatica, and gait disturbance.

Disability refers to neurological dysfunctions not necessarily related to CES such as motor weakness and/or paresis in the lower limbs.