Laboratory Studies
Laboratory studies are generally not indicated as a routine diagnostic tool in the evaluation of lumbosacral spine sprain/strain injuries.
Suggestive findings for rheumatic disease, such as ankylosing spondylitis, are increased levels of human leukocyte antigen (HLA)-B27, leukocytes (4.5-11 x 103), and erythrocyte sedimentation rate (ESR) (male: 0-20 mm/h; female: 0-30 mm/h).
Imaging Studies
Although sprain and strain injuries only involve the soft tissue, standard anteroposterior and lateral radiographs of the lumbar spine should be routinely obtained to (1) exclude a fracture, rheumatic disease, or a tumor growth; and (2) to evaluate degenerative joint disease as well as overall spinal alignment.
If an individual with LBP does not respond to conservative treatment and develops neurologic signs, a computed tomography (CT) scan or magnetic resonance image (MRI) may be considered to evaluate for disc herniation and involvement of the nerve roots. (See also the Medscape Reference articles Disk Herniation Imaging [in the Radiology section] and Herniated Nucleus Pulposus [in the Orthopedic Surgery section].)
