Diagnosis and Treatment of Low Back Pain

by Dr. P. Carl Rafey 22. August 2014 10:33

"Diagnosis and Treatment of Low Back Pain: A joint Clinical Practice Guideline from the American College of Physicians and the American Pain Society."

dr. carl rafey

Annals of Internal Medicine Oct2, 2007- Volume 147 issue 7- pages 478-491

In the above clinical guidelines article five recommendations are presented and explained to allow efficiency and consistency between health care providers in order to properly evaluate a patient with a low back complaint. 

The first recommendation is to conduct a thorough focused history and physical examination of the low back region.  After completion the patient will be placed in one of three categories. Category one is nonspecific low back pain. This involves sprain/strain, facet syndromes, and SI syndromes among other conditions. Category two of low back pain is nerve root or radicular pain.  In this category spinal stenosis and disc herniations come into play. The final category the patient could be placed in is category three which is back pain associated with another specific spinal cause (i.e. tumors, advanced spinal condition, and post surgical condition.)

The second recommendation put together in these guidelines is the fact that clinicians should not routinely obtain imagining or other diagnostic tests for patients in category one- non specific low back pain. 

Recommendation number three in these guidelines states that clinicians should perform diagnostic imaging and testing for patients with low back pain when severe or progressive neurologic deficits are present.

The fourth recommendation states that with patients with persistent low back pain and radicular pain the physician should evaluate the area with an MR or CT imagine.  The choice of imagining will vary with the specifics of the patient’s clinical symptoms. 

The fifth and final recommendation in the guidelines states the need for patient education with these conditions. Clinicians should provide patients with evidence-based information on low back pain.  Clinicians also need to be sure to inform the patients that staying active is important and also informing the patients of other effective self care options. 

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The Spinal Column

Comments (2) -

8/27/2015 4:07:06 AM #

I have always had back problems but not as severe as the one I'm having now. I have been to the chiropractor a half a dozen times. I have been to the massage therapist a half dozen times. I have had x-rays and blood work done. I have been to my Dr. and all he puts me on is painkillers. I do not want to rely on the meds, but no one can tell me what is bothering me.

9/13/2015 8:37:15 AM #

Very Informative site.
The information you are sharing is help me a lot.
Thank s for sharing this.

Comments are closed

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