Back pain is common but we want to make sure that Derrick has not got any serious underlying pathology.
** NICE suggests that overall evidence for the use of red flags that may indicate serious spinal pathology in the primary care setting is not strongly established. The review suggests suspicion of spinal fracture or malignancy should not be made on the presence of a single red flag feature alone.
It is vital not to miss cauda equina syndrome, it is rare but can have devestating consequences. Spinal cord compression can have the same consequences if missed. It can present with bladder, bowel or sexual disturbances.
The pain may remain on lying down, aching night time pain which disturbs sleep and thoracic pain (which can also be a sign of other causes like aortic aneurysm).