Rethinking yellow flags

The use of Yellow Flags has become widespread in clinical practice, as a means to identify clients with low back pain who might not respond favourably to physical treatments. However, using questionnaires to identify psychosocial risk factors that can result in ongoing pain and suffering is not a straightforward matter, and if used without due thought could result in an impoverished service for the client. This discussion article aims to raise awareness of the issues that emerge when relying on Yellow Flags; including the practicalities of using forced-choice questionnaires to identify complex interactions between a client's social environment and their psychological state. Yellow Flags are based on a biopsychosocial model of health, yet this paper argues that the use of Yellow Flags, in practice, belongs within a reductionist paradigm. By calling attention to the issues raised, we envisage a better utilization of the biopsychosocial model; whereby taking account of a client's unique experience and meaning of pain will enable the individual to be managed with a more genuine and insightful understanding than seemingly occurs at the present time.