ABSTRACT
The lifetime prevalence of low back pain has been reported to be 60–80%. By contrast, the lifetime prevalence of true sciatica is 2–4%. The commonest reasons for referral to a spinal clinic include pain and spinal deformity. A detailed history of the pain, including site, type, severity, duration, frequency and aggravating factors, should be sought. Palpation is useful to locate specific areas of tenderness. The normal range of motion in the cervical spine is 45° of flexion, 55° of extension, 70° of rotation and 40° of lateral bend. After taking a history and examining the patient it is important to consider ‘red flags’, which allow diagnostic triage into those with serious pathology of the spine, such as cauda equina syndrome, fractures, tumours and infection, and those without. Pain may arise from the spine, but non-spinal causes of pain must also be considered.
