Format

Send to

Choose Destination
Man Ther. 2016 Apr;22:68-71. doi: 10.1016/j.math.2015.10.003. Epub 2015 Oct 19.

Low back pain misdiagnosis or missed diagnosis: Core principles.

Author information

1
Centre for Musculoskeletal Studies, School of Surgery, The University of Western Australia, Perth, Western Australia 6009, Australia. Electronic address: aubrey.monie@research.uwa.edu.au.
2
Centre for Musculoskeletal Studies, School of Surgery, The University of Western Australia, Perth, Western Australia 6009, Australia.

Abstract

Consensus guidelines for the management of low back pain recommend that the clinician use contemporary best practice for assessment and treatment, consider biopsychosocial factors and, if chronic, use a multimodal and multi-disciplinary approach. Where guidelines are not followed and basic assessment is inadequate the diagnosis may be compromised and the sequelae of errors compounded. Factors such as a lack of knowledge or recognition of the common structure specific pain referral patterns, poor clinical reasoning, inappropriate referral and predilection for popular management approaches also contribute to mis-diagnosis and mis-management. This report describes two cases of chronic low back pain with lengthy histories of multiple failed interventions to highlight the consequences of focussing on a singular approach to the exclusion of evidence based pathways and the resulting risk of a missed diagnosis. The eventual management to mitigate these problems is reported with the aid of low back pain outcome measures, computer-aided combined movement examination, disability and pain questionnaires and health quality of life surveys.

KEYWORDS:

Assessment; Guidelines; Low back pain; Lumbar spine

PMID:
26521215
DOI:
10.1016/j.math.2015.10.003
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center