Diagnosis And Treatment Of Low Back Pain
Publication Date: January 1, 2020
Last Updated: March 14, 2022
Recommendations
Diagnosis
There is insufficient evidence to make a recommendation for or against the use of innominate kinematics for the assessment of sacroiliac joint pain. (I)
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There is insufficient evidence to make a recommendation for or against the use of pain localization in predicting response to a diagnostic injection. (I)
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There is insufficient evidence to make a recommendation for or against the assessment of centralization or peripheralization for the prediction of discography results. (I)
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There is insufficient evidence to indicate that body mass index (BMI) is a potential predictor of a recurrence of low back pain. (I)
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It is suggested that history of low back pain is a potential predictor of a recurrence of low back pain. (B)
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It is recommended that psychosocial factors and workplace factors be assessed when counseling patients regarding the risk of conversion from acute to chronic low back pain. (A)
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It is recommended that psychosocial factors be used as prognostic factors for return to work following an episode of acute low back pain. (A)
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It is recommended that pain severity and functional impairment be used to stratify risk of conversion from acute to chronic low back pain. (A)
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It is suggested that prior episodes of low back pain be considered a prognostic factor for the conversion from acute to chronic low back pain. (B)
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There is insufficient evidence to assess sleep quality as a prognostic variable to predict recovery from acute low back pain. (I)
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There is insufficient evidence to make a recommendation for or against the use of smoking and/or obesity as prognostic factors for the conversion from acute to chronic low back pain. (I)
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A nonstructural cause of low back pain may be considered in patients with diffuse low back pain and tenderness. (C)
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There is insufficient evidence to make a recommendation for or against the use of fear avoidance behavior to determine the likelihood of a structural cause of low back pain. (I)
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There is insufficient evidence to make a recommendation for or against the presence of diffuse back tenderness for the prediction of the presence of disc degeneration on radiographs. (I)
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There is insufficient evidence to make a recommendation for or against obtaining laboratory tests to assess for inflammatory disease in patients with sacroiliac joint pain. (I)
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Overview
Title
Diagnosis And Treatment Of Low Back Pain
Authoring Organization
North American Spine Society