Lower back pain diagnostics. Need to know

Three key questions when working out a persons back pain:

1. Are the symptoms the patient has reflecting a visceral disorder or a serious or potentially life-threatening disease?

2. From where is the patient's pain arising?

3. What has gone wrong with this person as a whole that would cause the pain to develop and persist?

The American College of Physicians currently recommends dividing the diagnosis into three categories:

1. Non specific LBP

2. LBP of radicular origin and spinal stenosis

3. LBP caused by pathology (eg malignancy) or other visceral source (e.g. renal)

Clarifying conditions arising from nociceptive pain:

Nociceptive pain:

- Clear proportionate mechanical/anatomical nature to the symtoms

- Pain in proportion to trauma/pathology

- Pain in area of injury/dysfunction with/without referral

- Resolving consistent with expected tissue healing time

- Usually intermittent and sharp with movement/mechanical provocation

- Pain in association with other symptoms of inflammation (e.g. swelling)

Discogenic pain:

- Centralisation phenomenon

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Lumbar Radiculopathy:

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Facet Joint Pain:

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Lumbar spinal stenosis:

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Lumbar discogenic pain:

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SIJ Pain:

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Piriformis syndrome:

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Seronegative spondyloarthropathies:

Quiz

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References / Articles / Resources

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