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Lower back pain diagnostics. Need to know

Updated: Apr 17, 2022

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

 

Lumbar Radiculopathy:


 

Facet Joint Pain:


 

Lumbar spinal stenosis:


 

Lumbar discogenic pain:



 

SIJ Pain:


 

Piriformis syndrome:



 

Seronegative spondyloarthropathies:




Quiz

 

 

References / Articles / Resources


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