Motor weakness on examination (not patient reported)*
Severe and acute radicular pain/sciatica (under three months) OR Bilateral radicular pain and unable to walk >10 mins
Myelopathy: referred limb pain/can't do up zips or buttons/loss of balance and hyper-reflexia (safety net link: click here)
Deformity: Scoliosis - Adolescent or young adult or Adult with kyphosis (clear postural deformity)
Over two weeks of static and not new cauda equina symptoms (pathway: click here and safety net: click here)
Had physiotherapy or spinal surgery