your disc bulge

is getting worse

Here is a list of warning signs that indicate your disc bulge problem may be deteriorating. You can discuss this at you intake exam.

red flags that suggest cauda equina syndrome include...

  • Severe or progressive bilateral neurological deficit of the legs, such as major motor weakness with knee extension, ankle eversion, or foot dorsiflexion.

  • Recent-onset urinary retention (caused by bladder distension because the sensation of fullness is lost) and/or urinary incontinence (caused by loss of sensation when passing urine).

  • Recent-onset faecal incontinence (due to loss of sensation of rectal fullness).

  • Perianal or perineal sensory loss (saddle anaesthesia or paraesthesia).

  • Unexpected laxity of the anal sphincter.

red flags that suggest spinal fracture include...

  • Sudden onset of severe central spinal pain which is relieved by lying down.

  • History of major or minor trauma, or even just strenuous lifting in people with osteoporosis.

  • Structural deformity of the spine (eg, a step from one vertebra to an adjacent vertebra).

  • Point tenderness over the vertebral body, or pathological fracture.

red flags that suggest a high risk of permanent damage to the compressed nerve include...

  • Significant muscle weakness or wasting.

  • Loss of tendon reflexes.

  • Presence of a positive Babinski reflex (toes extend and fan outwards when the lateral part of the sole of the foot is stimulated).

red flags that suggest cancer or infection include...

  • Onset in people older than 50 years, or younger than 20 years of age.

  • Pain that remains when supine, aching night pain that disturbs sleep, and thoracic pain.

  • Past history of cancer (breast, lung, gastrointestinal, prostate, renal, and thyroid cancers are more likely to metastasise to the spine).

  • Fever, chills or unexplained weight loss.

  • Recent infection (eg, urinary tract infection).

  • Intravenous drug misuse.

  • Immunocompromise such as HIV infection.

red flags that suggest spondyloarthropathy include...

  • Early morning stiffness lasting >45 minutes.

  • Night pain.

  • 'Gelling'.

  • Easier with movement/worse after rest.


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