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Musculoskeletal lower back pain

ბოლო მიმოხილვა: 19 Aug 2025
ბოლო განახლება: 02 Jul 2025

შეჯამება

განსაზღვრება

ანამნეზი და გასინჯვა

ძირითადი დიაგნოსტიკური ფაქტორები

  • obesity, stress, and psychiatric comorbidities
  • history of prior lower back pain
  • pain radiation does not extend beyond the knee
  • absence of red-flag symptoms
  • absence of fever, fluctuance, exquisite tenderness to palpation
  • sensory, motor, and deep-tendon reflex exams within normal limits
  • negative straight- or crossed straight-leg raise test
სრული ტექსტი

სხვა დიაგნოსტიკური ფაქტორები

  • dull, gnawing, tearing, burning, or electric pain associated with muscle spasms
  • lack of pain on flexion or relief on extension
  • scoliosis or kyphosis
  • negative FABER, Gaenslen, or Schober testing
სრული ტექსტი

რისკფაქტორები

  • obesity
  • family history of degenerative disk disease
  • poor musculotendinous flexibility and abnormal posture
  • stress and psychiatric comorbidities
  • increasing age
  • female sex
  • heavy physical and occupational activities
  • tobacco use
  • prolonged standing
  • vitamin D levels
სრული ტექსტი

დიაგნოსტიკური კვლევები

1-ად შესაკვეთი გამოკვლევები

  • clinical diagnosis
სრული ტექსტი

გასათვალისწინებელი კვლევები

  • lumbar spine MRI
  • lumbar spine x-ray
  • lumbar spine CT
  • myelography
  • CBC
  • erythrocyte sedimentation rate (ESR)
  • C-reactive protein (CRP)
  • urinalysis and culture
  • blood cultures
  • radionuclide bone scan
  • electromyogram (EMG)
სრული ტექსტი

მკურნალობის ალგორითმი

მწვავე

acute and subacute lower back pain (≤12 weeks)

მიმდინარე

chronic lower back pain (>12 weeks)

recurrent lower back pain

კონტრიბუტორები

ავტორები

Andrew Sherman, MD, MS

Professor and Vice Chair

Department of Physical Medicine & Rehabilitation

University of Miami Miller School of Medicine

Miami

FL

გაფრთხილება:

AS declares that he has no competing interests.

მადლიერება

Dr Andrew Sherman would like to gratefully acknowledge Dr Robert W. Irwin, Dr Louise Thwaites, Dr Karen Walker-Bone, Dr Joanne Borg-Stein, and Dr Philip Chiou, previous contributors to this topic.

გაფრთხილება:

RWI, LT, KWB, JBS, and PC declare that they have no competing interests.

რეცენზენტები

Jennifer Baima, MD

Staff Physiatrist

Orthopedic and Arthritis Center

Brigham and Women's Hospital

Chestnut Hill

MA

Disclosures

JB declares that she has no competing interests.

Alexios G. Carayannopoulos, DO, MPH

Interventional Spine Physiatrist

Pain Medicine Specialist

Medical Director

Spine Center

Lahey Clinic

Burlington

MA

Disclosures

AGC declares that he has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

American College of Radiology. ACR appropriateness criteria: low back pain. 2021 [internet publication].Full text

National Institute for Health and Care Excellence. Low back pain and sciatica in over 16s: assessment and management. Dec 2020 [internet publication].Full text

Qaseem A, Wilt TJ, McLean RM, et al. Noninvasive treatments for acute, subacute, and chronic low back pain: a clinical practice guideline from the American College of Physicians. Ann Intern Med. 2017 Apr 4;166(7):514-30.Full text  Abstract

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
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  • Patient information

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    Back pain: questions to ask your doctor

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