• 24th November 2017 at 6:23 am

    Does it wake you up at night? PainĀ  Backpain Freedom Reviewthat wakes the patient up at night is concerning and may represent a tumor or infection. This is called a red flag symptom.How did it start? If there was an injury or a fall a patient may have a fracture or ligamentous injury. For instance if the patient is a diabetic then infection is a significant concern especially if the blood sugars are not controlled and a recent hospitalization has occurred secondary to that problem. Let the patient explain fully the circumstances, it can open up the yellow brick road to the diagnosis.Any problems with bowel or bladder function? If there is a problem in the spine that is pressing on the anatomic area called the Cauda Equina, the most common problem seen is urinary retention. One also may have loss of bladder or bowel control. This is a red flag surgical emergency, as if it’s not surgically addressed within 24 to 48 hours that function may not return. Narcotics may cause constipation as well and that’s obviously not a surgical emergency.The most important part in obtaining a patient history is understanding what constitutes a red flag versus what is simply a normal back pain situation. The red flag situation requires further workup with potential imaging studies, bloodwork, or in rare circumstances like cauda equina syndrome emergency surgery.