Investigations & Diagnosis
- Risk stratification using Keele STarT Back tool
- Rule out red flags:
- Cauda equina syndrome (L4-L5, L5-S1): Sudden onset of b/l or u/l progressing to b/l radicular leg pain, saddle anaesthesia, urinary/bowel incontinence, erectile or sexual issues, laxity of anal sphincter
- Spinal fractures: Sudden pain relieved by lying down. History of trauma/strenuous activities. Point tenderness
- Spinal infections: Fevers, recent infections, DM, IV drug use and Immunosuppressed
- Cancer (metastases from breast, lung, renal, gastric, prostate primaries)