Background
A review and analysis of data from two US national surveys in 2002 found that 26.4% of respondents reported low back pain lasting at least a whole day in the past 3 months. [1] Lower back pain causes more global disability than any other condition. [2]
A standardized clinical examination of the lumbar spine is critical in the evaluation of patients with low back pain. Progressing in an orderly fashion through the different components of the examination ensures accuracy and repeatability.
Every examination should include inspection of the spine followed by active and passive range-of-motion testing, as well as manual muscle testing at the hip and spine. Finally, special testing and palpation are used to confirm findings appreciated earlier in the examination.
See Back Pain: Find the Cause, Watch for the Comeback, a Critical Images slideshow, to help diagnose and manage this common problem.
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Introductory discussion on the examination of low back pain.
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A discussion on the initial approach to the patient with acute low back pain.
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A discussion on visual inspection of the patient with acute low back pain.
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Overview of palpation in the examination of a patient with acute low back pain.
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A discussion of the role of range-of-motion testing in the evaluation of low back pain.
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A discussion of potential causes and symptoms based on patients' descriptions of low back pain.
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An introduction to and explanation of the straight leg raise test as part of an examination for low back pain.
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Demonstration of the straight leg raise technique.
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Explanation of the crossed straight leg raise in the evaluation of low back pain.
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Demonstration of dorsiflexion of the big toe as part of the evaluation of low back pain.
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Demonstration of Achilles reflex evaluation as part of the examination of low back pain.
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Demonstration of plantarflexion evaluation as part of the low back pain examination.
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Evaluation of dermatome sensation as part of the low back pain examination.
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Evaluation of the patella tendon reflex as part of the low back pain examination.
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A discussion of lumbar spinal stenosis as a cause of low back pain.
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Demonstration of the Romberg test to evaluate for proprioception in the examination of low back pain.