Table 1.

Visceral or potentially serious or life threatening diseases that can present as spinal pain.

Disorder	Detected by
Cancer	Previous history of CA, no position of relief, fever, constitutional symptoms, weight loss
Benign tumor	Localized severe pain, no position of relief, dramatic relief with NSAID, pain on percussion
Infection	History of fever and/or chills, fever on examination, pinpoint tenderness, redness or heat
Fracture	History of trauma, history of osteoporosis, pain on percussion
Seronegative spondyloarthropathy	Hx of iritis, AM stiffness, improvement with exercise, family Hx
GI disease	GI complaints, relation of pain to certain foods, abdominal examination
GU disease	GU complaints, bleeding, spotting, unusual discharge, GU examination
Myelopathy	Gait difficulties, bowel/bladder dysfunction, UMN signs, spasticity, sensory level
Cauda equina syndrome	Bowel/bladder difficulties, saddle anesthesia, decreased anal sphincter tone

CA – cancer; NSAID – non-steroidal anti-inflammatory drugs; Hx – history; AM – morning; GI – gastrointestinal; GU – genitourinary; UMN – upper motor neuron