Table 1

Screening questions relating to serious spinal pathology or systemic illness

High-level musculoskeletal safety questions
I now need to ask you some very important questions
1Since this problem in your back started have you had a sudden, severe, worsening pain in the middle of your abdomen and upper back?YesNo
2Do you have a new or recent problem in being able to pass urine?YesNo
3Do you have a new or recent loss of control of your bladder and/or your bowels?YesNo
3aHas your bladder been working properly? Can you tell when it is full? Have you felt that you want to ‘go’ all the time?YesNo
4Do you have numbness or altered feeling or pins/needles around your back passage or genitals, for example, wiping after being at the toilet?YesNo
5Since this problem in your back started have you had any heat, swelling or tenderness in your calf?YesNo
6Since this problem in your back started have you been unable to put any weight at all through your legs?YesNo
7Do you have constant pain that worsens at night?YesNo
8Do you have a history of cancer?YesNo
9Since this problem in your back started have you had any widespread or worsening weakness in your legs?YesNo
10Did this episode of pain start following a fall, or get much worse and stay bad following a fall?YesNo
11Do you have any chills or fevers or feel like you are running a temperature? (without other explanation)YesNo
12Do you have trouble with your balance while walking?YesNo
12a
  • If ‘Yes’ above, has this changed during the current episode?

YesNo