How do physical therapists know if low back pain is a serious medical condition?

Physical Therapists are well trained to recognize red flags throughout their evaluation. Red flags are signs and symptoms that raise suspicion of serious spinal pathology. These may come up in discussion of history or during examination. Some red flags merit immediate medical attention and/or imaging while others may need careful watch to assess response to treatment. Common serious conditions that physical therapists rule out through questioning and exam are cauda equina syndrome, spinal fracture, spinal malignancy and spinal infection. 

Common questions you may be asked during assessment include questions about fever, fatigue levels, night pain, bowel/bladder changes, sexual changes, gait and balance changes, weight changes, osteoporosis, sensation changes and strength changes.  Answers to these questions and examinations will help the physical therapist assess the need for immediate medical attention or not. Just because you may be experiencing one of the symptoms does not merit a serious condition. Signs and symptoms must fit in the whole clinical picture and diagnosis determined by a medical professional. 

Reflex testing

Manual resistive exercise to target thoracolumbar region