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Low Back Pain Clinical Evaluation
- Waddell Signs: tenderness, simulation, distraction, regional disturbances, and overreaction. Presence of 3 out of 5 signs strongly suggests nonorganic cause for LBP. (Waddell G, Spine 1980;5:117)
- Document location, severity and duration of pain as well as any aggravating ahd alleviating factors.
- Note any radicular pain especially if below the knee. (Sciatica)
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Low Back Pain Xray
- xrays generally not indicated for first 4-6 weeks due to benign nature and favorable prognosis. Early xrays are indicated if significant trauma has occured.
- MRI generally not indicated for first 4-6 weeks due to benign nature and favorable prognosis of most LBP. MRi indicated in patients with recnet infection, history of cancer, systemic symptoms(weight loss, fevers, chills), progressive neurologic deficit
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