Summary Back/Neck Pain

Summary of Risk Factors in Neck and Back Pain:
Historical Risk Factors Concern/Comments
Pain >6 wk Tumor, infection
Age <18 y old, >50 y old Congenital anomaly, tumor
Major trauma Fracture
Minor trauma in elderly or rheumatologic disease Fracture, age >50 y old is a risk for compression fracture, >70 y old is more specific for fracture
History of cancer Tumor
Fever and rigors Infection
Weight loss Tumor, infection
Injection drug use Infection
Immunocompromised Infection
Night pain Tumor, infection
Unremitting pain, even when supine Tumor, infection
Incontinence Epidural compression
Saddle anesthesia Epidural compression
Severe/progressive neurologic deficit Epidural compression
Anticoagulants and coagulopathy Epidural compression
Physical Risk Factors Concern
Fever Infection
Patient writhing in pain Infection
Unexpected anal sphincter laxity Epidural compression
Perianal/perineal sensory loss Epidural compression
Palpable bladder postvoiding Epidural compression
Major motor weakness/gait disturbance Nerve root or epidural compression
Positive straight leg raise test Herniated disk