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Chiropractic Research Review

Differential Diagnosis of Low Back Pain

Low back pain is among the common human conditions. It is experienced by perhaps one in five people. Many back complaints are mechanical in nature. But, as the author points out, "several of the uncommon diagnoses achieve a relatively great importance since they may result in severe neurological compromise or even death."

This article focuses on how best to rule out serious conditions and determine what problems are causing symptoms and contributing to disability.

It nicely explains three clinically useful diagnostic approaches:

* the "red flag approach"
* the "algorithmic approach"
* the "pattern recognition approach"

It provides detailed information on differential diagnosis and practical advice on how to use the various diagnostic approaches to get the clearest picture of the patient's condition so that appropriate treatment, or further diagnostic procedures, can be brought to bear.

The author concludes: "It is important to develop a systematic and logical approach to the patient with low back pain. Although the details of that approach are certainly flexible and will vary among practitioners, there are some features that are common to most logical approaches to the problem. Most such approaches include a search for the red flags which would prompt consideration of additional diagnostic testing to rule out serious underlying disease."

Note: This article can be an immensely valuable tool for chiropractors. It identifies the numerous possible causes of back pain and offers guidance in employing logical and sequential evaluation procedures to distinguish common and treatable conditions of the spine from more uncommon underlying conditions that require additional diagnosis and may pose significant threats to a patient's well-being.

Swenson RS. A medical approach to the differential diagnosis of low back pain. Journal of the Neuromusculoskeletal System, Fall 1998; 6(3), pp100-13. Reprints: Tel: (800) 342-0454; Fax: (410) 494-0515

Chiropractic Research Review

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