Low Back Pain Diagnostic Approach

Abstract

Low back pain is one of the leading causes of primary care and emergency room visits and job-related disability in many countries [1]. Back pain is sorted into three categories, differentiated by the duration of symptoms. Acute back pain, which is the focus of this article, is classified as pain lasting 6 weeks or less, subacute back pain is pain that has been present between 6 and 12 weeks, and chronic back pain is pain that persists longer than 12 weeks. Etiologies of low back pain include (but are certainly not limited to) mechanical injury (e.g., muscle sprain or spasm, ligament strain, facet joint disruption), arthritis, sciatica (lumbar radiculopathy), spinal fracture, malignancy, connective tissue disease, infection (e.g., vertebral osteomyelitis, epidural abscess), cauda equina syndrome, metabolic causes (e.g., hyperparathyroidism), abdominal or retroperitoneal visceral or vascular processes, psychogenic pain, and malingering. Careful history-taking and physical examination are crucial to diagnosing the etiology of back pain. This review presents the current state of science regarding the diagnosis and treatment of low back pain.