Identify Red Flag Conditions In Low Back Pain ( Low Back Pain )

Low back pain (LBP) is pain felt in the lower back area, it can be local pain, radicular pain or a mixture of both. This pain is felt between the corners of the lowest ribs and the lower crease of the buttocks, namely in the lumbar or lumbosacral area and can be accompanied by the spread of pain towards the legs and feet (PPK Neurology, 2016)

Low back pain is a symptom that can be caused by various abnormalities, both known and unknown; and is defined from its location, namely between costae XII and the buttock crease. This pain is often accompanied by pain in one or both legs and is associated with neurological symptoms in the lower extremities. This condition often occurs together with other conditions such as psychological, social and biophysical conditions so that it has an impact on the pain delivery process and the individual's pain experience (Cahya et al., JPHV 2021).

Low back pain can be classified according to its onset, namely acute low back pain (< 6 weeks), subacute (6 weeks – 3 months) and chronic (> 3 months). Lower back pain can be caused by infectious conditions, degenerative conditions, neoplasms, trauma, congenital disorders, metabolic diseases, and autoimmunity. Of the various etiologies, the most common cause of lower back pain is mechanical causes such as trauma to the vertebrae, discs and surrounding soft tissue. The second biggest cause is due to degenerative processes such as osteoarthritis and osteoporosis (Cahya et al., JPHV 2021).

Risk factors for lower back pain include excessive physical activity over a long period of time, stress and anxiety, lifting heavy weights regularly, being overweight and obese, and sitting for long periods of time. Based on the cause, low back pain can be divided into specific low back pain, radicular syndrome and nonspecific low back pain. The most cases in primary health facilities are nonspecific low back pain (90-95% of cases) which is often caused by mechanical disorders and degenerative conditions in the musculoskeletal system (Cahya et al., JPHV 2021).

Red flags low back pain if lower back pain occurs at age under 18 years, age over 50 years, use of anticoagulants, fever, infection, malignancy,    genitourinary symptoms (urinary retention or sexual dysfunction), immunocompromise, IV narcotics, history of recent actions -recently  or epidural injection. (Cahya et al., JPHV 2021).

Considering the various etiologies and disease burden of low back pain, it is necessary to make a correct and accurate diagnosis so that patients immediately receive therapeutic treatment appropriate to their condition (Macedonian Journal of Medical Sciences. 2021). The goal of low back pain therapy is to eliminate pain, inhibit progression and increase activity and mobility to improve the patient's function in life and the disabilities that can be caused by this condition. All therapy modalities must be based on recommendations not to do bed rest, remain active and carry out daily activities as usual (Cahya et al., JPHV 2021).

Pharmacological therapy, physiotherapy or medical rehabilitation, psychiatric therapy, alternative therapy and pain intervention therapy are relevant therapeutic options. Treatment for LBP is different for each individual, not all patients show the same response to treatment, and not all pain intervention therapies will be effective for all patients. (Macedonian Journal of Medical Sciences. 2021).

Signs that must be watched out for in  patients with  lower  back  pain  are  the  presence of red  flags  where  if  there  are  the  components  that  have  been  mentioned,  the  patient  must  get  referral  and  therapy  immediately.

Hermina Balikpapan Hospital with specialist polyclinic service facilities such as Neurology, Orthopedics and Traumatology as well as Physical Medicine and Medical Rehabilitation and equipped with the necessary examination facilities (Xray, CTScan and Laboratory) can be an option to get immediate treatment regarding low back pain complaints. pain ).