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DOI: 10.1055/s-0028-1109390
© Georg Thieme Verlag KG Stuttgart · New York
Red flags bei Patienten mit Schmerzen im Lendenbereich[1]
LiteraturstudieRed Flags in Patients with Low Back PainLiterature ReviewPublication History
Manuskript eingetroffen: 9.10.2008
Manuskript akzeptiert: 23.10.2008
Publication Date:
28 April 2009 (online)
![](https://www.thieme-connect.de/media/manuelletherapie/200902/lookinside/thumbnails/10.1055-s-0028-1109390-1.jpg)
Zusammenfassung
Im Rahmen des Direktzugangs zur Physiotherapie werden während des Screenings unter anderem Red flags eingesetzt, um eine eventuelle Überweisung zu einem Mediziner zu klären. Die Identifizierung und Definition von Red flags tragen zur Validität des Screening-Prozesses bei.
Die Literaturstudie suchte nach als Red flags beschriebenen Zeichen und Symptomen bei Patienten mit Schmerzen im Lendenbereich (LBP). Am häufigsten wurden die folgenden Red flags beschrieben: (1) Traumata, manchmal in Kombination mit Osteoporose, (2) erstmaliges Auftreten von Rückenschmerzen bei Patienten < 20 oder > 50 Jahre, (3) Malignität in der Krankengeschichte, (4) konstitutionelle und konditionelle Symptome wie Fieber, allgemeine Übelkeit und Gewichtsverlust, (5) Risikofaktoren für eine Wirbelsäuleninfektion wie intravenöser Drogenmissbrauch, Immunsuppression oder HIV, (6) neurologische Zeichen und Symptome wie Cauda-equina-Syndrom und (7) nächtliche Schmerzen.
In der Literatur fand sich keine übereinstimmende Formulierung von Red flags bei Patienten mit LBP. Die Definition von Red flags ist nicht eindeutig, aber der Hinweis auf ernsthafte Krankheiten steht im Mittelpunkt.
Abstract
Red flags, amongst other things, are used during screening processes within the scope of direct access physiotherapy. Screening aims to identify patients where further referral to a physician is necessary. Identifying and defining red flags contribute to the screening process’ validity.
This literature review aimed to search for signs and symptoms considered to be red flags in patients with LBP. The most frequently found red flags for low back pain were: (1) trauma, sometimes in combination with osteoporosis, (2) onset of LBP in patients < 20 and > 50 years of age, (3) history of malignancy, (4) constitutional and conditional symptoms such as fever, general nausea and weight loss, (5) risk factors for spinal infection such as intravenous drug abuse, immune suppression or HIV, (6) neurological signs and symptoms such as cauda equina syndrome, and (7) nocturnal pain.
There was no consensus concerning the definition of red flags in patients with LBP to be found in the literature. The definition of red flags is undetermined. However, the indication of a serious underlying pathology is in the focus.
Schlüsselwörter
Red flags - Direktzugang zur Physiotherapie - Literaturstudie - LBP
Key words
red flags - direct access physiotherapy - literature review - LBP
1 Der holländische Originalartikel ist erschienen in: Nederlands Tijdschrift voor Fysiotherapie 2008; 118: 19 – 27.
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1 Der holländische Originalartikel ist erschienen in: Nederlands Tijdschrift voor Fysiotherapie 2008; 118: 19 – 27.
Drs. Pauline Arnold
Praktijk fysiotherapie/manuele therapie
Pastor Hendrikspark 34
1251 MD Laren
Niederlande
Email: paulinearnold@euronet.nl