Acute Low Back Problems in Adults: Assessment and Treatment

• [Front Matter]
• Attention Clinicians:
• Abstract
• Suggested citation
• Purpose and Scope
• Initial Assessment
• Medical History
• Physical Examination
• Addressing Red Flags
• Observation and Regional Back Examination
• Neurologic Screening
• Testing for Muscle Strength.
• Circumferential Measurements.
• Reflexes.
• Sensory Examination.
• Clinical tests for sciatic tension
• Inconsistent Findings and Pain Behavior
• Initial Care
• Patient Education
• Patient Comfort
• Oral Pharmaceuticals
• Physical Methods
• Activity Alteration
• Avoiding undue back irritation.
• Avoiding debilitation.
• Work Activities
• Special Studies and Diagnostic Considerations
• Timing and Limits of Special Studies
• Selection of Special Studies
• Management Considerations After Special Studies
• Surgical Considerations
• Direct and indirect nerve root decompression for herniated discs.
• Management of spinal stenosis.
• Further Management Consideration
• Availability of Guidelines
• [Tables]
• Table 1. Red flags for potentially serious conditions
• Table 2. Symptom control methods
• Table 3. Guidelines for sitting and unassisted lifting
• Table 4. Ability of different techniques to identify and define pathology
• Table 5. Summary of Guideline Recommendations
• [Figures]
• Figure 1. Testing for lumbar nerve root compromise.
• Figure 2. Instructions for the Straight Leg Raising (SLR) Test
• Figure 3. Instructions for sitting knee extension test.
• [Algorithms]
• Algorithm 1. Initial evaluation of acute lew back problem.
• Algorithm 2. Treatment of acute low back problem on initial and followup visits.
• Algorithm 3. Evaluation of the slow-to-recover patient (symptoms > 4 weeks)
• Algorithm 4. Surgical considerations for patients with persistent sciatica.
• Algorithm 5. Further management of acute low back problem.