Pavilion Publishing and Media Ltd
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Self-reported back pain is common at any age; however, as a new symptom in elderly people it requirescareful assessment because it may signal a serious disorder. The challenge is to maintain clinicalvigilance for detection of cancer, infections or serious spinal disorders, since benign axial back painaffects a substantial proportion of the population. Red flags assist in obtaining key features in thehistory and examination that may relate to sinister pathology such as malignancy, infection andcauda equina syndrome. Knowing what and when to refer to a spine specialist such as an orthopaedicsurgeon or neurosurgeon is important. Spinal-cord compression and loss of the structural integrityof the spine may require specialist skills for decompression and reconstruction. Management is oftenmultidisciplinary, involving oncologists or infectious-disease specialists, and surgeons.
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