Mechanical Back Pain Questions & Answers

Updated: Aug 27, 2020
  • Author: Debra G Perina, MD; Chief Editor: Trevor John Mills, MD, MPH  more...
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Questions & Answers

Overview

What is mechanical back pain?

What are the American College of Radiology appropriateness criteria for imaging mechanical back pain?

What causes mechanical back pain?

How do nerve root syndromes cause mechanical back pain?

Which musculoskeletal pain syndromes cause mechanical back pain?

What are the signs and symptoms of myofascial-related mechanical back pain?

What are the signs and symptoms of fibromyalgia-related mechanical back pain?

What are the skeletal causes of mechanical back pain?

What is the prevalence of mechanical back pain?

What is the morbidity and mortality associated with mechanical back pain?

Which patient groups have the highest prevalence of mechanical back pain?

What is the prognosis for mechanical back pain?

What is included in patient education about mechanical back pain?

Presentation

What is the focus of the clinical history to evaluate mechanical back pain?

How are psychosocial issues affecting mechanical back pain assessed?

What is the focus of the physical exam to evaluate mechanical back pain?

Which physical exam findings are characteristic of mechanical back pain caused by stenosis?

Which physical exam findings are characteristic of mechanical back pain caused by sacroiliitis?

Which physical exam findings are characteristic of mechanical back pain caused by osteomyelitis?

Which physical exam findings are characteristic of mechanical back pain caused by herniated discs?

DDX

What are the differential diagnoses for Mechanical Back Pain?

Workup

What is the role of lab testing in the workup for mechanical back pain?

What is the role of imaging studies in the workup for mechanical back pain?

What is the role of CT and MRI in the workup for mechanical back pain?

What is the role of ultrasonography in the workup for mechanical back pain?

Which results on a straight leg raising test are positive for mechanical back pain?

How is claudication differentiated from pseudoclaudication?

Treatment

What is included in prehospital care for acute mechanical back pain?

How is acute mechanical back pain treated in the emergency department (ED)?

What is conservative treatment for mechanical back pain?

What are the American Pain Society recommendations for the treatment of nonradicular mechanical back pain?

What are the American Pain Society recommendations for the treatment of persistent radicular mechanical back pain?

Which specialist consultations are beneficial to patients with mechanical back pain?

What is the role of a primary care provider in the treatment of mechanical back pain?

What is the role of spinal manipulation in the treatment of mechanical back pain?

What is the role of physical therapy in the treatment of mechanical back pain?

What are the reported benefits of stratified management of mechanical back pain?

When is inpatient care indicated for the treatment of mechanical back pain?

When is transfer indicated for the treatment of mechanical back pain?

How is mechanical back pain prevented?

Guidelines

Which organizations have released guidelines on the diagnosis and management of mechanical back pain?

What are the ACR Appropriateness Criteria for lower back pain imaging?

What are the American College of Physicians (ACP) guidelines on lower back pain treatment?

What are the United Kingdom's National Institute for Health and Care Excellence (NICE) guidelines on lower back pain treatment?

What are the American Pain Society (APS) guidelines on chronic lower back pain treatment?

Medications

What is the role of medications in the treatment of mechanical back pain?

Which medications in the drug class Analgesics are used in the treatment of Mechanical Back Pain?

Which medications in the drug class Muscle relaxants are used in the treatment of Mechanical Back Pain?

Which medications in the drug class Nonsteroidal anti-inflammatory agents (NSAIDs) are used in the treatment of Mechanical Back Pain?