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Table 3 Red flags endorsed unrelated to specific disease

From: Red flags presented in current low back pain guidelines: a review

Red flag Endorsed by guideline
Pain
  Onset of pain <20 or >50 years old Austria, Europe, Malaysia, Norway, Philippine, Spain
  Constant, progressive, nonmechanical pain Canada, Europe, Philippine
  No pain relief with bed rest Europe
  Thoracic (or abdominal) pain Austria, Europe, Malaysia, Philippine, Spain
  (Continuous) Pain at resta Austria, Canada, Malaysia, New Zealand, Norway
  (Increasing) Pain at nighta,c Canada, Malaysia, New Zealand
  Pain increase in flexion Austria
  Increasing pain despite treatment Austria
  Pain at night that is not eased by a prone position (or increasing in supine position)a Philippine
History of malignancies/cancera Austria, Canada, Europe, Malaysia, New Zealand, Norway, Philippine, Spain
(Unexplained/unintentional) Weight lossa Austria, Canada, Europe, Malaysia, New Zealand, Norway, Philippine
Fever ≥38 °Ca,c Austria, Canada, Europe, Malaysia, New Zealand, Philippine, Spain
General malaisea Austria, Norway, Spain
Elevated erythrocyte sedimentation (ESR)a Norway
Age over 50 yearsa New Zealand
(History of) Major/significant traumab Austria, Europe, Malaysia, New Zealand, Norway, Philippine, Spain
(Structural spinal) deformityb Austria, Europe, Malaysia, Norway, Spain
(Systemic) Use of steroidsb Malaysia, New Zealand,
Osteoporosisb Austria, Malaysia
Intravenous drug abuse/drug addictionc Austria, Europe, Malaysia, New Zealand, Norway, Spain
Use of corticosteroids or immunosuppressant therapyc Austria, Europe, Norway, Philippine, Spain
Immunodeficiency/HIV/AIDSc Austria, Europe, Malaysia, Philippine, Spain
Saddle anesthesia/perineal numbnessd Malaysia, Philippine
(Sudden onset) Bladder dysfunction (e.g. urinary retention, overflow incontinence)d Malaysia, Philippine
(Wide) Spread sensory deficit (in lower limbs)d Austria, Canada, Europe, Norway, Spain
Progressive weakness in lower limbs/lower motor neuron weaknessd Malaysia
Gait disturbance/abnormalityd Malaysia
Progressive weakness in lower limbs/lower motor neuron weaknessd Malaysia
Significant limitation of lumbar flexion Malaysia, Philippine
Not flexion of 5th lumbar spine Spain
Morning stiffness Norway
  1. aEndorsed elsewhere for malignancy, b endorsed elsewhere for fracture, c endorsed elsewhere for infection, d endorsed elsewhere for CES
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