What are the key clinical features that differentiate non-specific low back pain from serious underlying conditions?

Non-specific low back pain is generally considered unlikely to have a serious structural cause, with most individuals recovering within weeks ¹,².

Key clinical features that differentiate non-specific low back pain from serious underlying conditions, prompting emergency hospital admission or specialist referral, include the presence of red flag symptoms or signs ¹,². It is important to consider alternative diagnoses, particularly if new or changed symptoms develop ¹,²,³.

Serious underlying pathologies to exclude include cancer, infection, trauma, or inflammatory diseases such as spondyloarthritis ³. Specific red flag symptoms for suspected cancer related to back pain include:

• Back pain with unexplained weight loss in individuals aged 60 and over ⁴.
• Persistent back pain in individuals aged 60 and over ⁴.