Overview of Lumbar Spine Assessment
Introduction[edit | edit source]
Low back pain is the leading cause of disability in most countries,[1] with a point prevalence of 11.9%.[2] Years lived with disability caused by low back pain are continuing to increase, and the socioeconomic burden of low back pain is high.[3] Around half of all individuals with low back pain seek care,[4] and it is estimated that around 60 percent of patients presenting to a primary care physician have a complaint of low back pain.[5] It is, therefore, important that rehabilitation providers have a comprehensive understanding of the lumbar spine evaluation. This page provides an overview of this evaluation and includes links for more information.
History[edit | edit source]
When assessing patients with low back pain, age can help us formulate hypothetical diagnoses about the potential pathoanatomical cause of pain:[6]
- individuals aged less than 20 years old: low back pain is rare (apart from muscle sprains), so check for anomalies (e.g. spondylolisthesis)
- individuals aged between 20 and 50 years: more likely a disc pathology, muscle strain or instability
- individuals aged more than 50 years: more likely associated with degeneration, so consider conditions such as arthritis or spondylosis
The mnemonic L-M-N-O-P-Q-R-S-T is used to cover the key aspects you should consider when taking a patient’s history.
References[edit | edit source]
- ↑ GBD 2021 Low Back Pain Collaborators. Global, regional, and national burden of low back pain, 1990-2020, its attributable risk factors, and projections to 2050: a systematic analysis of the Global Burden of Disease Study 2021. Lancet Rheumatol. 2023 May 22;5(6):e316-e329.
- ↑ Bastos RM, Moya CR, de Vasconcelos RA, Costa LO. Treatment-based classification for low back pain: systematic review with meta-analysis. Journal of Manual & Manipulative Therapy. 2022 Jul 4;30(4):207-27.
- ↑ Dutmer AL, Schiphorst Preuper HR, Soer R, Brouwer S, Bültmann U, Dijkstra PU, et al. Personal and societal impact of low back pain: the Groningen Spine Cohort. Spine (Phila Pa 1976). 2019 Dec 15;44(24):E1443-E1451.
- ↑ Almeida M, Saragiotto B, Richards B, Maher CG. Primary care management of non-specific low back pain: key messages from recent clinical guidelines. Med J Aust. 2018 Apr 2;208(6):272-5.
- ↑ Gibbs D, McGahan BG, Ropper AE, Xu DS. Back pain: differential diagnosis and management. Neurol Clin. 2023 Feb;41(1):61-76.
- ↑ Cunningham S. Lumbar Spine Evaluation Course. Plus, 2024.
