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

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Posted: 14 August 2025Updated: 14 August 2025 Guideline-Aligned (High Confidence) Clinically Reviewed
Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX

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

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 ,. It is important to consider alternative diagnoses, particularly if new or changed symptoms develop ,,.

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

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

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