There are certain signs and symptoms that spine specialists know could represent a potentially serious spine disorder; these signs and symptoms are sometimes referred to as “red flags�. These presentations usually require a comprehensive workup and timely intervention. The list below represents some of the red flags.

Neck or back symptoms associated with one or more of the following presentations:

• Known or previous cancer
• Bowel or bladder dysfunction
• Recent spinal trauma
• Pain unrelieved by rest or any postural modification
• Pain unchanged despite care for 2-4 weeks
• Pain associated with antalgia and inability to stay still or inability to move
• Colicky pain or pain associated with abnormal organ (viscera) function
• Fever or known immunosuppressed status
• High risk for fracture (older age, osteoporosis, chronic steroid therapy)
• Numbness or tingling in the trunk and/one or more extremity when moving the neck (L’hermitte’s Sign)
• Associated fatigue, malaise, and/or weight loss
• Progressive neurological impairment (weakness, sensory loss)
• Severe morning stiffness as the primary complaint
• Symptoms causing a patient to be unable to care for themselves.