When Pain May Signal Something Serious – Recognizing Red Flags in Musculoskeletal Disorders

by Son’s Rehabilitation Medicine & Chiropractic Clinic in Seoul

Musculoskeletal pain is one of the most common reasons patients visit clinics. It can result from posture problems, muscle overuse, aging, or mild trauma. Fortunately, most of these cases improve with conservative care such as manual therapy, rehabilitation exercises, and lifestyle modification.

However, not all pain is benign.

Some symptoms may indicate a more serious underlying condition, and identifying these “Red Flags” is critical for early diagnosis and proper management.

🔴 What Are Red Flags?

In medical practice, Red Flags refer to signs and symptoms that may point to serious or potentially life-threatening conditions, such as infections, cancer, fractures, or neurological compromise.

International clinical guidelines recommend further evaluation—often including imaging or lab tests—when one or more Red Flags are present.

🚩 Evidence-Based Red Flags in Musculoskeletal Pain

1. Unexplained Weight Loss

Reference: NICE Guidelines (UK), 2016 – Low Back Pain and Sciatica in Adults
Losing a significant amount of weight without trying may suggest cancer, chronic infection, or systemic illness. In patients with a prior history of cancer, this symptom requires urgent investigation.

2. Night Pain or Pain That Disrupts Sleep

Reference: American College of Physicians Clinical Practice Guideline, 2007
Pain that worsens at night or wakes you from sleep may be a sign of spinal tumors, vertebral infections, or inflammatory arthritis such as ankylosing spondylitis.

3. Recent Trauma or Falls

Reference: North American Spine Society (NASS) Guidelines, 2020
Especially in elderly patients, even minor trauma can cause compression fractures or ligament injuries. Imaging (X-ray, MRI) may be needed even when the injury appears mild.

4. Neurological Symptoms

Reference: American Academy of Neurology (AAN)
Numbness, tingling, muscle weakness, or difficulty with bowel/bladder control can suggest nerve compression or spinal cord involvement. These signs must be evaluated immediately.

5. History of Cancer

Reference: Diagnostic Imaging Pathways (Western Australia Government)
Musculoskeletal pain in patients with a previous cancer diagnosis should always raise suspicion for possible metastasis, especially if pain is deep, persistent, or not related to movement.

6. Signs of Infection or Immune Suppression

Reference: Infectious Diseases Society of America (IDSA)
Fever, chills, or a weakened immune system (e.g., diabetes, steroid use, chemotherapy) can increase the risk of bone or joint infections like osteomyelitis or septic arthritis.

🩺 Our Clinical Approach at Son’s Spine & Rehabilitation

At Son’s Spine & Rehabilitation Clinic, we approach each patient with care and diligence. Even if the pain seems mild, we routinely assess for Red Flags during consultation. When necessary, we perform diagnostic imaging (X-ray, ultrasound) or coordinate with hospitals for advanced evaluations (MRI, blood work).

Our mission is to provide safe, evidence-based care and to identify hidden risks early—so that treatment can be timely and effective.

✅ Takeaway

While most cases of musculoskeletal pain are harmless and improve with proper therapy, it’s essential not to overlook warning signs. If your pain is persistent, worsening at night, or accompanied by any unusual symptoms mentioned above, please seek medical evaluation without delay.

Listening to your body’s subtle warnings can make all the difference.

If you have concerns or questions, feel free to contact us at Son’s Spine & Rehabilitation Clinic. We’re here to help you move safely and live fully. 

👍Consultation and Appointment Information

Son PMR & Chiropractic Clinic( 2nd floor, 229-1 Gucheonmyun-Ro, Gangdongu, Seoul, South Korea) 

by  Dr Son MD & DC 
Contact: 02-482-8875 in Seoul( +82-2-482-8875)

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