Spinal Health

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🩺 About this screening tool

Our red flag screening tool is designed to help you make sense of your lower back problem and work out whether booking an appointment with us is the right next step. It can also highlight if your situation might be better managed by your GP, or if urgent medical attention is needed. Think of it as a simple guide to point you in the safest direction before you decide what to do next.
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We’ll present you with questions to help us better understand your lower back symptoms and circumstances. We’ll be checking for the presence of “red flags” — signs or symptoms that may indicate a more serious underlying condition. Although serious medical causes of lower back problems are rare, it’s important to screen for their presence. And if a "red flag" is identified, it's important that we refer you to an appropriate healthcare professional for further assessment.
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Red Flag Screening Overview:

We will ask you about the presence of symptoms across eight "red flag" categories.

Unassessed trauma

Infection

Underlying disease such as cancer

Cardiovascular pathology

Central nervous system and neurological pathology

Inflammatory and autoimmune conditions

Bone health and fracture risk

Complications from recent surgery
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First Up: Screening for Unassessed Trauma
Let’s begin by asking whether you’ve had a recent fall, accident, or forceful physical event that could be linked to your current back problem — and whether it’s been assessed by a medical professional.
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Do you believe your current lower back problem was caused or made worse by a recent fall, accident, or other forceful physical event?* This field is required.
I have had a recent fall, trauma, or forceful physical event and I do believe it is relevant to my current lower back problem.
I have had a recent fall, trauma, or forceful physical event. But I do not believe it is relevant to my current lower back problem
I have not had any recent fall, trauma, or forceful physical event in association with my current lower back problem
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Since your recent fall, trauma, or forceful physical event, have you consulted with a Medical Doctor or Healthcare Professional for an in-person physical assessment?* This field is required.
Yes- Since my recent fall, trauma, or forceful physical event, I have had a formal assessment with a Medical Doctor or Healthcare Professional who cleared me of any injury diagnosis, and advised that there was no need for further diagnostic investigations.
No- Since my recent fall, trauma, or forceful physical event, I have not consulted with a Medical Doctor or Healthcare Professional for a formal assessment.
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⚠️ Important Notice – Recent Trauma Without Medical Assessment

You’ve indicated that you’ve had a recent fall, accident, or other forceful incident that hasn’t yet been checked by a healthcare professional. This raises concerns about a possible structural injury, such as a fracture or significant tissue damage, as the cause of your back problem.

The safest next step is to have a thorough, in-person assessment. We can examine your back, arrange any necessary imaging, and guide you on the most appropriate management.

Please book an appointment with us via the following link
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Thanks for completing our screening questions related to unassessed trauma. If you were prompted to book an appointment, please note that by continuing beyond this point, you are doing so for informational purposes only.

In the next section, we’ll screen for signs of infection that may be presenting as a lower back problem.
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Screening for Symptoms of Infection as a Cause of Your Lower Back Problem

While it might sound strange to ask about infection within the context of a lower back problem, we’re not talking about a cold or a flu, we’re screening for the possibility of a more serious local or systemic infection that could be contributing to your symptoms.

Certain infections — such as a spinal or sacroiliac abscess, or a deep wound infection — can sometimes present as lower back pain. That’s why this next question is important. It’s not intended to diagnose you, and a lack of symptoms doesn’t definitively rule infection out. But it does help us determine whether your situation raises enough concern to recommend further assessment.
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Have you recently experienced any of the following symptoms in association with your current lower back problem?* This field is required.
Fever or chills
Unexplained fatigue
Night sweats
Feeling ‘off’ without knowing why
Feeling generally ill or unwell
None of the above
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unexplained_infection_symptom_count
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🔴 Red Flag Alert: Possible Underlying Infection

Your answers suggest a combination of symptoms that could indicate an active infection. This may or may not be related to your back problem, but it’s important to take this possibility seriously.

The safest next step is to see a medical doctor promptly for further assessment. If your symptoms are severe or worsening, please seek urgent care at your nearest emergency department.

At this stage, we don’t recommend booking directly for physiotherapy until infection has been ruled out. Once it is safe, we can support you with a tailored rehabilitation plan to help your recovery.
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Thanks for completing our screening questions related to signs of infection. If you were advised to seek further medical assessment, please note that by continuing beyond this point, you are doing so for informational purposes only.

In the next section, we’ll screen for signs of underlying disease such as cancer that may be presenting as a lower back problem.
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Screening for Underlying Health Conditions

Serious underlying conditions, such as cancer, are uncommon in people with lower back problems. Still, it’s important to check for any warning signs before moving forward.

The questions that follow are not a diagnosis. Their purpose is simply to flag whether your symptoms might require further medical evaluation. A “no red flags” result doesn’t guarantee everything is normal, but if any concerns are identified, we want to help you take the safest next step.

If anything concerning comes up, we can guide you on whether to see your GP, a specialist, or arrange an assessment with us.
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Have you recently noticed any of the following (with no clear explanation)?* This field is required.
Unexplained weight loss
Loss of appetite
Ongoing fatigue that doesn’t improve with rest
Persistent night pain that wakes you or doesn't improve with position changes
A general feeling of being unwell or “not quite right”
None of the above
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Cancer_risk_calculator* This field is required.
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⚠️ Important Notice – Possible Signs of a Serious Condition

Your responses indicate a combination of symptoms that can sometimes be associated with a serious underlying condition, such as cancer. This may or may not be related to your back problem, but it’s important to be cautious.

The safest next step is to see a qualified healthcare provider for a thorough assessment. If your symptoms are severe or worsening, please seek urgent care at your nearest emergency department.

At this stage, we don’t recommend proceeding with physiotherapy until any serious condition has been ruled out. Once it is safe, we can provide a personalised plan to help manage and rehabilitate your back effectively.
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Thanks for completing our screening questions related to signs of underyling disease such as cancer. If you were advised to seek further medical assessment, please note that by continuing beyond this point, you are doing so for informational purposes only.

In the next section, we’ll screen for signs of underlying cardiovascular disease that may be presenting as a lower back problem.
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Screening for Cardiovascular Drivers of Your Lower Back Problem

Although rare, some heart or circulatory conditions can present as lower back pain. It’s important to check for these possibilities to ensure your safety as you consider next steps.

The following questions are not a diagnosis. They simply help identify whether your symptoms might require further medical assessment beyond what this screening tool can offer. A “no red flags” result doesn’t guarantee everything is normal, but if any concerns are detected, we want to help you take the safest next step.

If anything concerning arises, we can guide you on whether to see your GP, a specialist, or arrange an assessment with us.
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Have you experienced any of the following symptoms recently, either with or just before the onset of your current lower back problem?* This field is required.
Pressure, tightness, squeezing, or burning sensation in the chest
Shortness of breath with mild activity
Light-headedness or fainting episodes
Unexplained sweating, especially at rest or at night
Back pain that worsens with cardio exercise such as walking, but improves with rest
Pain in your chest, jaw, or left arm
Sudden, severe, or “tearing” pain in your lower back or abdomen?
Deep or throbbing abdominal pain, rather than muscular or sharp pain
Nausea, indigestion, or a feeling of fullness
None of the above
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Calculator_Cardiovascular_Risk
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⚠️ Important Notice – Possible Cardiovascular Involvement

Your responses suggest a combination of symptoms that could indicate an underlying cardiovascular issue contributing to your back pain. While this is uncommon, it’s important to be cautious.

The safest next step is to have a thorough assessment with a qualified healthcare provider. If your symptoms are severe, worsening, or associated with chest pain, shortness of breath, dizziness, or other concerning signs, seek urgent medical attention immediately.

At this stage, we don’t recommend proceeding with physiotherapy until cardiovascular causes have been ruled out. Once it is safe, we can develop a personalised plan to help manage your back effectively.
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Thanks for completing our screening questions related to signs of cardiovascular disease. If you were advised to seek further medical assessment, please note that by continuing beyond this point, you are doing so for informational purposes only.

In the next section, we’ll screen for signs of underlying neurlogical disease that may be presenting as lower back symptoms.
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🧠 Screening for Neurological Conditions Involving the Brain, Spinal Cord, or Upper Motor Neurons

While many lower back problems are mechanical in nature and involve localised nerve irritation or muscle strain, some symptoms can indicate more serious neurological conditions affecting the brain, spinal cord, or upper motor neurons.

These conditions are uncommon — but when present, they often require medical attention. That’s why we check for certain neurological “red flags” that help us determine whether your symptoms might be part of a more serious condition like spinal cord compression, multiple sclerosis, or other central nervous system disorders.

The following questions focus on things like coordination, balance, bladder or bowel function, changes in sensation, and any unusual symptoms affecting both sides of your body. This process helps us decide whether it's best for you should to speak with a healthcare professional in person before proceeding any further.
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🧠 Have you experienced any of the following in association with your current lower back problem?* This field is required.
Numbness, tingling, or altered sensation in both arms or both legs
Difficulty coordinating movements or feeling unusually clumsy
A sense of imbalance or feeling unsteady when walking
Recent changes in your ability to control bladder or bowel function
Numbness or altered sensation in the inner thighs, groin, or saddle area
Changes to your vision such as double vision or blurry vision, or loss of vision in one eye
Weakness or heaviness in both arms or both legs
Sudden severe dizziness or vertigo
Unusual difficulty with swallowing or speaking
Sudden onset, "worse ever" headache
Sudden weakness or numbness on one side of the body (face, arm, or leg)
Loss of consciousness or fainting episodes
None of the above
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Calculation_Neuro.Symptoms
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⚠️ Important Notice – Neurological Symptoms Requiring Assessment

Your responses suggest symptoms that may indicate a neurological issue. While this isn’t a diagnosis, some neurological conditions can be serious — and occasionally urgent — involving the brain, spinal cord, or nervous system.

If your symptoms are sudden, worsening, severe, or include loss of bladder or bowel control, progressive weakness or numbness, changes in speech or vision, or sudden unsteadiness, seek immediate medical attention at an emergency department or urgent care centre.

If your symptoms have developed gradually, or you’re unsure of their significance, it’s important to follow up with your GP or another qualified healthcare provider as soon as possible. A thorough in-person assessment can clarify whether further investigation or referral is needed.

At this stage, we don’t recommend proceeding with physiotherapy until any serious neurological issues have been ruled out. Once it is safe, we can provide a personalised plan to manage your back effectively.
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Thanks for completing our screening questions related to signs of neurological disease. If you were advised to seek further medical assessment, please note that by continuing beyond this point, you are doing so for informational purposes only.

In the next section, we’ll screen for signs of autoimmune and inflammatory conditions that may be presenting as a lower back problem.
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Screening for Inflammatory or Autoimmune Conditions
While most lower back problems are mechanical in nature — meaning they’re influenced by body position, movement, or load — there is a small group of people whose back symptoms are driven by underlying systemic inflammatory or autoimmune conditions.

This type of back problem doesn’t behave the same way as a typical strain or flare-up. Symptoms can be subtle or mistakenly attributed to other causes, so it’s important to screen carefully.

The next question helps identify whether your current lower back problem could be part of an undiagnosed inflammatory condition. It’s not intended to provide a diagnosis — only to identify if your symptoms raise the level of suspicion and warrant a referral for further medical investigation.
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Have you experienced any of the following in association with your lower back problem?* This field is required.
A family history of conditions like ankylosing spondylitis, psoriasis, inflammatory bowel disease, or uveitis
A personal history of an autoimmune disease (e.g. Ankylosing spondylitis, Crohn’s, ulcerative colitis, psoriatic arthritis)
Back pain that improves with movement but not with rest
Morning stiffness lasting more than 30 minutes
Back pain that began before the age of 40
Back pain that has lasted more than 3 months
Pain that wakes you during the second half of the night
Alternating pain in both buttocks
Swelling or inflammation in joints, tendons, or at the heel
A known positive HLA-B27 blood test
Episodes of eye inflammation (iritis or uveitis)
Persistent fatigue or general malaise along with back symptoms
None of the above
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Inflammatory_Symptom_Calculator
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⚠️ Important Notice – Possible Inflammatory or Autoimmune Cause

Your responses suggest a pattern of symptoms that could be linked to an inflammatory or autoimmune condition. These conditions can sometimes mimic mechanical back pain but often follow a different course and require medical management.

While this isn’t a diagnosis, your symptoms warrant further assessment to differentiate a possible autoimmune/inflammatory cause from a more common and typical musculoskeletal cause. We recommend you book an appointment with us via the following link
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Thanks for completing our screening questions related to symptoms of inflammatory or autoimmune conditions. If you were advised to seek further medical assessment, please note that by continuing beyond this point, you are doing so for informational purposes only.

In the next section, we’ll ask about risk factors for osteoporosis and bone health and weigh the possible presence of an underlying fracture as part of your lower back problem.
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📘 Screening for Risk of Osteoporotic Fracture
Lower back pain can sometimes be caused by a spinal fracture — even without a major fall or accident. This is more likely in people with low bone density, a condition known as osteoporosis. These types of fractures are called fragility fractures, and they can occur from everyday movements like bending, lifting, or twisting.

Because these fractures often happen without a clear injury, they can be mistaken for ordinary back pain. That’s why we ask a few short questions to help us identify whether you're at risk. If certain risk factors are present, it may be safest to recommend a medical assessment to rule out a fracture before continuing with this tool.
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Have you experienced any of the following, either recently or in the past, that may indicate a risk of low bone density or fragility fracture?* This field is required.
A known diagnosis of osteoporosis or osteopenia
A history of low-impact fractures (e.g. from a fall from standing height)
Loss of height over time or a noticeable stooped posture
Use of corticosteroid medication (e.g. prednisone) for more than 3 months
Early menopause (before age 45) or surgical removal of ovaries
Family history of osteoporosis or hip fractures
Low body weight or history of eating disorder
Smoking or heavy alcohol consumption
None of the above
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Bone Density Risk Calculation
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⚠️ Important Notice – Increased Risk of Reduced Bone Density

Your responses suggest you may be at increased risk of reduced bone density or osteoporosis. This is important because weaker bones can make the spine more vulnerable to fractures, even from everyday activities or minor incidents, and could be contributing to your back problem.

While this isn’t a diagnosis, your answers indicate it’s wise to book an appointment with us to further assess your symptoms. You can book an appointment via the following link.
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Thanks for completing our screening questions related to osteoporosis and fracture risk. If you were advised to seek further medical assessment, please note that by continuing beyond this point, you are doing so for informational purposes only.

In the next section, we’ll ask about any recent medical procedures or surgeries you might have had that could possibly be linked to your current lower back problem.
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🩺 Screening for Recent Surgery or Medical Procedures
Before we move on, we need to ask whether you've recently had any recent surgery or medical procedure. This is important because, in some cases, a lower back problem may actually be related to a complication or side effect of recent medical or surgical treatment — even if it doesn't seem directly connected.

For example, surgery involving the abdomen, spine, pelvis, or joints can sometimes lead to infections, altered biomechanics, or referred pain patterns that present as back pain. Similarly, the use of medical devices (such as spinal hardware or catheters) or prolonged immobility during recovery can also be relevant.

The next question helps us identify whether your current symptoms may be linked to a recent surgical or medical event that requires further investigation or follow-up care.
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Have you had any of the following surgeries or medical procedures in the past 3 months?* This field is required.
Spinal surgery of any kind (e.g. discectomy, spinal fusion, decompression)
Joint replacement surgery (e.g. hip, knee, shoulder)
Abdominal or pelvic surgery (e.g. hernia repair, hysterectomy, prostate surgery)
Recent hospitalisation or prolonged bed rest for a medical condition
A surgical wound near your spine, pelvis, or hip that has not healed properly or has shown signs of infection (e.g. redness, discharge, fever)
Use of any implanted medical device or catheter (e.g. spinal hardware, urinary catheter, surgical drain)
None of the above
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Surgery_infection_calculator_risk
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⚠️ Important Notice – Recent Surgery or Medical Procedure Alert

Your responses suggest that you've recently undergone surgery or a medical procedure. In some cases, recent surgeries — particularly involving the spine, joints, or abdomen — or medical events like prolonged bed rest, healing complications, or use of implanted devices, can contribute to new or worsening symptoms. It’s important that any lower back problem arising in this context is carefully assessed in person by a qualified healthcare professional.

We recommend booking an appointment for a more detailed assessment through a clinical consultation — just follow the link.
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✅ Red Flag Screening Complete

You’ve now completed our red flag screening process.

If you were prompted to seek urgent medical attention, it’s important to act on that immediately.

If you were advised to see your GP, please arrange an appointment as soon as possible.

If you were advised to book an assessment with us, please do so via this link

If you received no red flag alerts, this is reassuring — it means there’s no indication of a serious underlying condition. However, since you do have a back problem, the next best step is still to book a physiotherapy consultation. This will help identify what’s contributing to your symptoms and allow us to develop a personalised plan to get you moving comfortably and safely.
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