Acute low back pain usually refers to a period of less than two to four weeks. There are various diagnostic groupings for patients with low back pain. The classifications center on clinical findings, history of patient and response to treatment. Mechanical causes involving the spine are the etiology for most patients with acute low back pain. This is because of the weak link between symptoms, examination results, and anatomic change. Diagnosis of non-mechanical causes such as an infection or cancer has greater certainty but signifies a small portion of acute low back in primary care (Willis, 1999).
A patient’s history and physical examination largely determines the extent to which a caregiver searches for a precise diagnosis. History and physical examination helps identify patient’s exposure to the risk of low back pain and those with neurologic compromise that warrants thorough evaluation and treatment. Furthermore, history and physical examination of patients helps in identifying issues that may affect choice of therapy or prolong pain (Swezey, 2006).
Clinicians should follow relevant guidelines to boost the appropriateness of diagnostic testing in primary evaluation of patients with acute low back pain. A short physical exam is necessary since most patients do not report all symptoms or other risk issues relating to the low back pain. For instance, for efficient assessment, patients should be standing for posture, flexibility, and spine symmetry. On the other hand, assessment of the hip for range motion and pain is necessary for back pain with groin symptoms (Waddell, 1996).
History and physical examination also helps in identification of patients at high risk for persistent symptoms due to psychological and social factors. For instance, histories of depression, substance abuse, or socio-economic status are consistent with persistence of low back pain. Early identification of these factors can boost the outcome of care. Some strategies ...
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