Low Back Pain and Sciatica – You Must Be Aware of the Red Flags

Low Back Pain and Sciatica – You Must Be Aware of the Red Flags

The majority of low back pain and sciatica suffered by the general population is ‘non-specific’ in nature and can be resolved by the individual themselves who is suffering with that pain, as long as they know what to do.

However, there are a few rare occurrences where there may be another cause of the pain, and some of these causes we refer to as Red Flags. Although, rare, if you feel you recognise any of the signs and symptoms I mention in this article, it is imperative you see a health professional first for a thorough assessment.

The remainder of this article will highlight the Red Flags you must be aware of if you are suffering with Low Back Pain &/or Sciatica.


i) Cauda Equina Syndrome (CES)

At approximately the level of the first/second lumbar vertebra, the spinal cord itself finishes and the nerves form a group together referred to as the Cauda Equina, Latin for ‘horse’s tail’, which it is said to resemble. If there is any kind of compression on the nerves in this region, typically by a prolapsed disc, it does not allow these nerves to function correctly. Typical signs and symptoms would be as follows:

a) Decreased Bladder and Bowel Control

Having a lack of control over your bladder &/or bowel. Be this difficulty in emptying your bladder or bowel or the opposite where you have difficulty in stopping yourself from emptying your bladder/bowel.

b) Saddle Paraesthesia (numbness and/or ‘pins and needles’)

This refers to a feeling of numbness or pins and needles in the saddle area i.e. in between the legs, genitalia, inner thigh or buttock area

c) Sexual Dysfunction

This could be in the form of impotence or loss of ejaculation/orgasm.

If you feel you may be suffering with CES, it is important you seek immediate medical advice. Contact your GP immediately and inform them of your signs and symptoms and wait for their advice as to the next step you should take. If, for whatever reason, you are unable to speak to your GP, visit your local Accident & Emergency (A&E) Department.

It is important I also state here that pain and subsequent medication can also give similar signs and symptoms to CES. Therefore, if you do recognise any of the above signs & symptoms it may be because of the pain you are in or the medication you are taking, not because you have CES.

ii) Unexplained Weight Loss

If you are losing a significant amount of weight and you cannot explain why, you need to visit your GP so they can look into this in more detail. Although rare, the reason for any unexplained weight loss may also be the reason why you are suffering with low back pain &/or sciatica.

iii) Fever and Night Sweats

If you feel you are suffering with a prolonged fever and/or night sweats, I suggest you visit your GP to have this checked out.

iv) History of Cancer

Just because you have a history of cancer, this does not mean it is related to the low back pain &/or sciatica you are currently suffering with. Nevertheless, it would be wise to check your current condition out with your GP/Health Professional first, so as to be sure there is no relationship between the two.

v) Progressive Neurological Deficit

By this, I typically mean pins and needles, numbness and/or weakness. If you have any of these signs and symptoms, and feel they are getting worse, it is best to see your GP/Health Professional.

As I mentioned at the very beginning of this article, Red Flags are very rare. Nevertheless, if you are suffering with Low Back Pain &/or Sciatica, it is very important to be aware of them and the associated signs & symptoms.

Although rare, if you do recognise any of the above Red Flags, you do need to see your GP. The only real medical emergency of the above is CES, where you need to visit your GP or local A&E department as soon as is possible.

I hope you have enjoyed reading about Red Flags. I know it is not a topic which is going to help you resolve the pain you are suffering, but it is vitally important information you should be familiar with if you, or anyone you know, is suffering with low back pain or sciatica.

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