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Accurate diagnosis of LBP may be difficult and requires a comprehensive approach. However, the history and physical examination may elicit warning signals that indicate the need for further work-up and treatment. These "red flags" include a history of trauma, fever, incontinence, unexplained weight loss, a cancer history, long-term steroid use, parenteral drug abuse, intense localized pain and back pain that is increased or unrelieved by rest.
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