Red Flags

Severe pain is very frightening, especially when it’s the first time we suffer a new type of pain i.e. it’s in a new place or when it's so bad it interrupts our day to day living. This is a problem, as fear and anxiety can sometimes “amplify or turn up” the pain simply making things worse.

The irony is that pain (even when severe..) in isolation is not necessarily a serious symptom, it is normally just the bodies way of telling you that something is wrong with the musculo-skeletal system e.g. muscles, joints, ligaments, tendons, etc.

The purpose of this blog is to try to help patients decide when it is time to see an osteopath and when they should see the doctor for further medical examination/testing. As osteopaths we use a system called red flags. 

Red flags are a list of signs and symptoms that if a patient tells us they are suffering, we need to consider whether there is something more medically serious going on, and decide whether to refer back to the doctor for further tests.

It is very difficult to write a definitive list, as humans are effected by so many different conditions and diseases, and these all present differently in different people. Equally, just because you have something from the list doesn’t mean you are definitely medically ill, it just means healthcare professionals need to consider your problem a little more carefully.

Here are the main ones that make me think a patient MIGHT NOT be appropriate for osteopathic treatment/manual therapy:


A high temperature (fever)- this can be a sign of systemic illness

Unexplained weight lose- emphasis here is on the "unexplained" 

A swelling or a deformity in your back- lumps and bumps anywhere need investigating!

It’s constant and doesn't ease after lying down- this sounds less mechanical

It’s getting worse not better- progressive pain can be a sign of an ongoing process

Pain in your chest- could be a sign of heart or lung problems

A loss of bladder or bowel control (retention or incontinence)

An inability to pass urine or stool 

Numbness around your genitals or back passage 

It's worse at night- although a lot of straight forward musculo-skeletal pain can be bad at night too!

It started after an accident or impact- it could be a fracture

Worsening weakness in muscle groups

Bilateral pain/tingling/numbness i.e. into both arms or both legs

Symptoms all down one side i.e. same sided arm and leg

Rapid change in vision, hearing, taste or smell

Problems talking, swallowing or controlling the muscles of your face

Passing out- losing consciousness


Please remember that just because you have something on the list it doesn’t mean you are necessarily seriously unwell, it just means you should get it checked out!

I hope this list is useful for patients that are considering booking into the practice for treatment. I have shared it in order that patients can make the right choice about where they seek treatment, and get the right care for them.

Please remember that the vast majority of people that suffer pain have simple musculo-skeletal problems which can be easily treated at the Bexleyheath Osteopathic Practice. 

Call us on 020 8298 7122 to book an appointment if you think we can help you.


© Bexleyheath Ostepathic Practice 2013