Identifying when not to treat is one of the most important skills any medical professional can learn. This is particularly the case for primary care practitioners such as chiropractors and GPs, who can see any patient that makes an appointment for virtually any reason.
Because referral to other specialists is so routine, patients should always feel safe visiting a chiropractor even if unsure as to whether chiropractic treatment is the right intervention for them.
There are, however, times when patients themselves can identify when conservative treatment may not be appropriate, or when further investigation is warranted. It is important not to cross over into self-diagnosis at this point, but knowledge of a number of key criteria can be very helpful in sourcing the correct treatment.
These criteria, so called red-flags, are symptoms that could indicate underlying disease and therefore require medical scrutiny.
When considering lower back pain, severity is not a red flag. As counter-intuitive as it may sound, having more severe pain does not necessarily mean you have a more severe problem in your back, and does not correlate with underlying disease.
Red flags for lower back pain are predominantly focused on bowel and bladder involvement and trauma. Although the spine is formidably strong and very difficult to damage, a severe trauma can cause fractures to vertebra.
Very occasionally, lower back pain can be associated with constipation, urinary urgency or incontinence, all of which constitute red flags. Numbness in the saddle area may occur at the same time.
Unexplained weight-loss and feelings of fever are also red flags, possibly pointing to a systemic problem.
Fortunately, nearly all back pain is due to a simple cause and can be easily treated, and not due to disease.