Back pain
differential diagnosis of back pain
Lancet 2017;389:736 & Continuum 2021;27:12
initial evaluation of back and spinal cord disease
- differential diagnosis of back pain
- History taking of back and spinal cord disease
- general physical exam of back pain:
- signs of radiculopathy (sharp/lancinating pain radiating into limb):
- Neurogenic claudication in lumbar stenosis (see table on next page)
- Neuro exam of back and spinal cord disease
- Red flags of back and spinal cord disease:
- Laboratory of back and spinal cord disease
- Neuroimaging: low yield if nonradiating pain, high false ⊕ rate (incidental spondylosis); depending on suspicion: X-rays, CT or CT myelography, MRI, bone scan
- EMG/NCS: may be useful to distinguish root/plexopathies from peripheral neuropathies