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Observation
According to Koes et al. (2010), the following summary can be made regarding LBP diagnosis.
Beginning with physical examination, perform an examination with the following elements:
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Inspection
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ROM
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Posture – kyphosis and lordosis
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Palpation
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Mobility
The guidelines from Europe, Australia and Spain explain to use caution when testing ROM, posture and inspection due to their low reliability and validity.
Examination
Testing should first begin with identification of red flags and exclusion of specific diseases (Koes et al. 2010). These red flags indicate specific low back pain and could include:
- Age at onset (<20 or >55 years)
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Significant trauma
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Unexplained weight loss
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Widespread neurological changes
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Fever
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Thoracic pain
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Structural spinal deformity
Special tests
Questionnaires
Testing of pain and functional limitations should also be tested, using valid and reliable tests.
Diagnostic Imaging
The abnormalities in X rays and MRI and the occurrence of non-specific low back pain seem not to be strongly associated, as abnormalities found when imaging people without back pain are just as prevalent as those found in patients with back pain (Koes et al. 2006).
Differential Diagnosis
According to this initial examination, a neurological screening should be performed with the following elements:
- Strength
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Reflexes
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Sensibility
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SLR
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Lasegue
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