Mechanical low back pain facts and differential diagnosis

Did you know two thirds of all Americans experience low back pain at some point in their lives? Or that low back pain is the second most common complaint in ambulatory care? Or is the third most expensive with only heart disease and cancer surpassing it?

When a patient is experiencing low back pain diagnoses range from the common sprain to the rare and serious cauda equina syndrome. Differential diagnosis of these conditions is critical, so it’s good practice for providers who regularly treat low back pain to offer patients some cautionary advice such as: “If you experience bladder or bowel incontinence, saddle type numbness in the buttocks or profound weakness, you should go to emergency room immediately.” Symptoms, like these indicating cauda equine syndrome, if ignored can produce devastating outcomes with permanent paralysis.

The Agency for Healthcare Research and Quality (AHRQ) has published ACR Appropriateness Criteria® for low back pain on their website. To take the Medscape quiz on low back pain and test your knowledge, click here.