What are yellow flags in PT practice?

• A. Psychosocial prognostic factors (e.g., kinesiophobia, depression, anxiety, catastrophizing) that, if unaddressed, increase risk of chronic pain and poor recovery outcomes.
• B. Physiological signs of tissue damage.
• C. Insurance-related barriers to care.
• D. Nutrition-related risk factors.

Answer: (A)

Yellow flags are psychosocial prognostic factors that, if unaddressed, increase the risk of chronic pain and poorer recovery outcomes. They reflect how beliefs, emotions, and social context influence a patient’s response to pain and their engagement with treatment. For example, fear of movement (kinesiophobia), catastrophic thinking about pain, anxiety, and depression can lead to avoidance of activity, reduced adherence to rehabilitation, and slower progress, even when the physical tissue might not be severely damaged. Recognizing these factors helps clinicians adopt a biopsychosocial approach, addressing beliefs and coping strategies, providing education, and using graded activity or exposure, with referrals to psychology if needed. These are not signs of tissue damage (those are red flags), nor are they barriers to care related to insurance, nor nutrition-related risks.