Although most patients suffering from lower back pain find relief after simple treatments, proper diagnosis is crucial in determining more serious underlying pathologies. The symptoms of lower back pain considered as `red-flag` symptoms, including neoplastic problems, infection, cauda equina syndrome and vertebral fractures, are often indicators of more serious pathologies. The presence of these symptoms require the patient to be directed to a spine surgeon for a more in-depth evaluation.

It is reported that psychosocial factors also play an important role in long term disability and a delay in return-towork due to lower back pain. A color-coded `flag` system in addition to the `red-flag` list of symptoms has been developed to assist clinicians in evaluating psychosocial factors. According to this system, a `blue flag` defines a patient whose work-related perceptions affect the recovery of his lower back. While many `blue flag` symptoms have been identified, literature suggests that the best prognostic indicator of recovery is expectation to return to work.