This is one reason for asking Red Flag questions and taking vitals.

I had a 27 year old female that came in for a new problem of left low back pain. I had previously treated her for intermittent right low back pain and right leg pain following a L4 diskectomy 7 years prior. She is not a real good historian. However, I was able to determine that her pain was gradually worsening over the past 5 days and she didn't recall any specific causal onset. The one thing that caught me was that she felt that this was a different type of pain that she had ever felt before.

Her vitals were all normal except a low grade fever of 99.2 degrees. She had a difficult time trying to sit and refused to bend forward at her waist. Although she didn't have any fever or chills she admitted to having night sweats, a general fatigue and ill feeling, new headaches to include her whole head and general spinal pain. By having her put her chin to her chest she felt pain extend into both shoulders and from the low back into both buttocks.

My immediate impression was that of a viral meningitis. I called her M.D. and he was able to work her in right away. Following tests it was confirmed that she did have viral meningitis.

Had I not being persistent in asking the red flag questions in different ways of this poor historian and had I not taken her vitals I may have misdiagnosed this case and simply would have treated her, obviously with a poor outcome.

The Best Practices in Chiropractic Academy really opened my eyes as to the many possible causes of back pain. It taught me to do a better job of listening to what my patients are telling me and to make sure I take vitals on my patients.
David Fisher, DC, CCST, DACRB, Duluth MN