In spite of our strong intent to be accurate, did you know, regardless of the doctor, there is only about a 45% accuracy rate when making a low back pain diagnosis?
1. Red flags - These include dangerous conditions such as cancer, infection, fracture, equina cauda syndrome (a severe neurological condition where bowel and bladder function is impaired). These conditions generally require emergency care due to the life threatening and/or surgical potential.
2. Mechanical back pain - These diagnoses include facet syndromes, ligament and joint capsule sprains, muscle strains, degenerative joint disease (also called osteoarthritis), and spondylolisthesis.
3. Nerve Root compression - These conditions include pinching of the nerve roots, most frequently from herniated discs. This category can include spinal stenosis (SS) or, combinations of both, but if severe enough where the spinal cord is compromised (more commonly in the neck), SS might then be placed in the 1st of the 3 categories described above.
The most common category is mechanical back pain of which facet syndrome and muscle strains are the most common conditions. This is the classic patient who over did it ("The Weekend Warrior") and can hardly get out of bed the next day. These conditions can include tearing or stretching of muscle fibers and surrounding joints due to performing too much bending, lifting, or twisting related activities. The back pain is usually localized to the area of injury but can radiate down into the buttocks or back of the thigh and can be mild to very severe.