Back pain diagnostic study of choice: Difference between revisions
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**Detailed history | **Detailed history | ||
**[[Physical examination]] | **[[Physical examination]] | ||
**Identification of red flags | **Identification of red flags<ref name="pmid31899561">{{cite journal| author=Welk B, Baverstock R| title=Is there a link between back pain and urinary symptoms? | journal=Neurourol Urodyn | year= 2020 | volume= 39 | issue= 2 | pages= 523-532 | pmid=31899561 | doi=10.1002/nau.24269 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=31899561 }} </ref><ref name="pmid25790449">{{cite journal| author=Lumley MA, Schubiner H, Carty JN, Ziadni MS| title=Beyond traumatic events and chronic low back pain: assessment and treatment implications of avoided emotional experiences. | journal=Pain | year= 2015 | volume= 156 | issue= 4 | pages= 565-566 | pmid=25790449 | doi=10.1097/j.pain.0000000000000098 | pmc=4369787 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25790449 }} </ref><ref name="pmid8434327">{{cite journal| author=Polatin PB, Kinney RK, Gatchel RJ, Lillo E, Mayer TG| title=Psychiatric illness and chronic low-back pain. The mind and the spine--which goes first? | journal=Spine (Phila Pa 1976) | year= 1993 | volume= 18 | issue= 1 | pages= 66-71 | pmid=8434327 | doi=10.1097/00007632-199301000-00011 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8434327 }} </ref><ref name="pmid25125938">{{cite journal| author=Mabry LM, Ross MD, Tonarelli JM| title=Metastatic cancer mimicking mechanical low back pain: a case report. | journal=J Man Manip Ther | year= 2014 | volume= 22 | issue= 3 | pages= 162-9 | pmid=25125938 | doi=10.1179/2042618613Y.0000000056 | pmc=4101555 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25125938 }} </ref> | ||
***[[Intestine|Bowel]] [[incontinence]] | |||
***[[Urinary bladder|Bladder]] [[incontinence]] | |||
***Progressive [[weakness]] in [[legs]] | |||
***[[Sleep]] interrupted due to severe [[back]] [[pain]] | |||
***[[Fever]] | |||
***[[Depression]] | |||
***Unexplained [[weight loss]] | |||
***[[Back]] [[pain]] due to [[trauma]] | |||
***Increased [[back]] [[pain]] in [[patients]] with [[osteoporosis]] or [[multiple myeloma]] | |||
***Repetitive intense [[exercise]] involving lumbar [[extension]] | |||
***Long term [[corticosteroid]] use (can cause [[fractures]]) | |||
**[[Imaging]], if indicated (preferably an [[MRI]]) | **[[Imaging]], if indicated (preferably an [[MRI]]) | ||
**Laboratory evaluation ([[CBC]], [[ESR]], [[CRP]], [[ANA]], [[RF]], [[LDH]], [[uric acid]], [[HLA-B27]]) | **Laboratory evaluation ([[CBC]], [[ESR]], [[CRP]], [[ANA]], [[RF]], [[LDH]], [[uric acid]], [[HLA-B27]]) | ||
Latest revision as of 21:49, 29 May 2021
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Back pain Microchapters |
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Diagnosis |
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Treatment |
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Lecture |
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Case Studies |
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Back pain diagnostic study of choice On the Web |
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American Roentgen Ray Society Images of Back pain diagnostic study of choice |
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Risk calculators and risk factors for Back pain diagnostic study of choice |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Zehra Malik, M.B.B.S[2]
Overview
There is no single diagnostic study of choice for the diagnosis of back pain. Back pain is a symptom of an underlying condition, emphasis should be made in identifying the etiology. The diagnostic plan should include, a detailed history, physical examination, identification of red flags, imaging (preferably an MRI) and laboratory evaluation (CBC, ESR, CRP, ANA, RF, LDH, uric acid, HLA-B27).
Diagnostic Study of Choice
- There is no single diagnostic study of choice for the diagnosis of back pain.
- Back pain is a symptom of an underlying condition, emphasis should be made in identifying the etiology.
- The diagnostic plan should include:[1][2]
- Detailed history
- Physical examination
- Identification of red flags[3][4][5][6]
- Bowel incontinence
- Bladder incontinence
- Progressive weakness in legs
- Sleep interrupted due to severe back pain
- Fever
- Depression
- Unexplained weight loss
- Back pain due to trauma
- Increased back pain in patients with osteoporosis or multiple myeloma
- Repetitive intense exercise involving lumbar extension
- Long term corticosteroid use (can cause fractures)
- Imaging, if indicated (preferably an MRI)
- Laboratory evaluation (CBC, ESR, CRP, ANA, RF, LDH, uric acid, HLA-B27)
References
- ↑ Wang H, Cheng J, Xiao H, Li C, Zhou Y (2013). "Adolescent lumbar disc herniation: experience from a large minimally invasive treatment centre for lumbar degenerative disease in Chongqing, China". Clin Neurol Neurosurg. 115 (8): 1415–9. doi:10.1016/j.clineuro.2013.01.019. PMID 23419406.
- ↑ Gran JT, Husby G (1995). "HLA-B27 and spondyloarthropathy: value for early diagnosis?". J Med Genet. 32 (7): 497–501. doi:10.1136/jmg.32.7.497. PMC 1050539. PMID 7562959.
- ↑ Welk B, Baverstock R (2020). "Is there a link between back pain and urinary symptoms?". Neurourol Urodyn. 39 (2): 523–532. doi:10.1002/nau.24269. PMID 31899561.
- ↑ Lumley MA, Schubiner H, Carty JN, Ziadni MS (2015). "Beyond traumatic events and chronic low back pain: assessment and treatment implications of avoided emotional experiences". Pain. 156 (4): 565–566. doi:10.1097/j.pain.0000000000000098. PMC 4369787. PMID 25790449.
- ↑ Polatin PB, Kinney RK, Gatchel RJ, Lillo E, Mayer TG (1993). "Psychiatric illness and chronic low-back pain. The mind and the spine--which goes first?". Spine (Phila Pa 1976). 18 (1): 66–71. doi:10.1097/00007632-199301000-00011. PMID 8434327.
- ↑ Mabry LM, Ross MD, Tonarelli JM (2014). "Metastatic cancer mimicking mechanical low back pain: a case report". J Man Manip Ther. 22 (3): 162–9. doi:10.1179/2042618613Y.0000000056. PMC 4101555. PMID 25125938.