Last reviewed: November 2017
Last updated: November  2017

Important updates

UK guidelines from the National Institute for Health and Care Excellence (NICE) on low back pain and sciatica in over 16s

The recommendation from the NICE guideline on low back pain and sciatica to not routinely offer imaging in a non-specialist setting for people with low back pain with or without sciatica has been highlighted in the update of this topic. Comments have been added on when imaging may be considered.

See Diagnosis: approach

Original source of update

UK guidelines from NICE on spondyloarthritis in over 16s

Following publication of the NICE guideline on spondyloarthritis, we have highlighted that the diagnosis of spondyloarthritis is often not considered, leading to delays in effective treatment.

See Diagnosis: approach

Original source of update

Summary

Differentials

Common

  • Lumbar muscular strain/sprain
  • Herniated nucleus pulposus (HNP)
  • Spinal stenosis
  • Compression fracture
  • Degenerative disk disease or facet arthropathy

Uncommon

  • Spondylolysis and/or spondylolisthesis
  • Vertebral discitis/osteomyelitis
  • Malignancy
  • Inflammatory spondyloarthropathy
  • Connective tissue disease
  • Aortic abdominal aneurysm
  • Pancreatitis
  • Pyelonephritis
  • Renal colic
  • Peptic ulcer disease

Contributors

Authors VIEW ALL

Daniel K. Park

Assistant Professor

Department of Orthopedic Surgery

William Beaumont Hospital

Royal Oak

MI

Disclosures

DKP has acted as a consultant for Stryker and K2M. DKP holds stock in Johnson and Johnson.

Kern Singh

Professor

Department of Orthopedic Surgery

Rush University Medical Center

Chicago

IL

Disclosures

KS has received royalties from Zimmer, Stryker, Pioneer, Lippincott Williams & Wilkins, Thieme, Jaypee Publishing, and Slack Publishing. He holds stock in Avaz Surgical, LLC, and Vital 5, has consulted for Depuy, Zimmer, and Stryker, and is on the board of directors for CSRS, ISASS, AAOS, SRS, Vertebral Column - ISASS. KS has received a CSRS resident grant.

Dr Daniel K. Park and Dr Kern Singh would like to gratefully acknowledge Dr Howard S. An, a previous contributor to this topic. HSA declares that he has no competing interests.

Peer reviewers VIEW ALL

Professor of Medicine

Mayo Clinic College of Medicine

Division of Rheumatology

Rochester

MN

Disclosures

ELM declares that he has no competing interests.

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