Kim has written this blog about this serious topic of red flags. These are the problems that need to be picked up early by a health professional and usually (but not always) mean that manual therapy and physio isn’t appropriate, but definitely need further medical investigation.
What are red flags?
No, we are not talking Game of Thrones…… that ship has sailed. House Lannister’s red flag underwent a serious BBQ…….. (Editor’s note – whatever that means!)
When we are talking about red flags, we are talking about signs of serious pathology.
Unfortunately, sometimes the body can’t heal itself and sometimes we do need further medical intervention. This is important and we are here to help recognise this.
We have written blogs before about the overuse of imaging and surgery. We have also written before about brain changes and persistent pain. We have talked about the safety of movement and the benefits of exercise.
These are all true but first we need to make sure there is nothing serious going on. This is our number one job!
Once we have done this, we are safe to move forwards in our management – a green light if you will.
Physiotherapists are highly trained to recognise when symptoms are of serious concern – we call these Red Flags.
How do you find these red flags?
Red Flags will show up in questioning and physical examination.
They are signs and symptoms which indicate risk of the person having serious pathology and they warrant further investigation.
Often these clues indicate conditions where physiotherapy is not helpful and not what the person needs. Sometimes the red flags can be medical emergencies (though these are rare, thankfully!)
Conditions like cancer, infection and fractures cannot be fixed with physiotherapy, surprisingly!
Having said that, physio may well have an important role to play after the condition has been identified and medically managed. For example, after appropriate fracture management, physio is really important. Physio has a really important role to play in recovery from cancer and cancer treatments.
There may have been times in the past when you have been questioned by your physio about things which may have seems strange or unrelated. It is likely that they were screening for red flags.
Symptoms such as, recent unexplained weight loss, numbness, loss of control of bladder or bowels, unremitting night pain or a history of cancer are some of the questions which will often be asked.
These symptoms alone often are not enough to warrant further investigation but combined with other information the physio will clinically reason to determine if further investigations or referrals are warranted.
Once you have undergone a thorough assessment your physiotherapist will be able to determine whether you are safe to move.
Red flags and persistent pain
In persistent pain states (sometimes called chronic pain), it is a typical concern from clients that there is something nasty going on. Pain has a way of making you feel this way – your brain is trying to protect you!
It is important to rule out these pathologies so that we can reassure you that this is not the case.
In some situations, this is where further investigations are useful. Blood tests, further imaging and referral to specialists can be helpful to rule these things out.
These days, physiotherapists are often the first medical contact in injury and pain management.
Our training allows us to screen for serious pathology which must occur to give you the all clear so that you can move safely!