Clinical approach to chronic low back pain among specialists

Document Type : Original article

Authors

1 Department of Radiology, Shahid Beheshti University of Medical Sciences, Tehran, Iran

2 Endoscopic and Minimally Invasive Surgery Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

3 Clinical Research Unit, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

4 Clinical Research Development Unit, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran & Orthopedic Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

5 Department of Community Medicine, Mashhad Branch, Islamic Azad University, Mashhad, Iran

6 Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

7 Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

8 Department of internal medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

Abstract

Background
Low back pain is a common reason for disability in patients younger than 45 years old who visit physicians. Although there are many attitudes toward treating back pain, there is no commonly accepted approach. This study compared various attitudes toward the examination, diagnosis, and treatment of chronic low back pain among neurologists, neurosurgeons, and orthopedic surgeons.
Methods
In this cross-sectional study, a checklist including four main aspects of history taking, clinical and para-clinical tests, and treatment of chronic low back pain was designed to be completed by 45 specialists (orthopedic surgeons, neurosurgeons, and neurologists).
Results
Straight Leg Raising (SLR) was the most frequent test during the examination process. The high priorities among the para-clinics were MRI, lumbosacral graph, EMG-NCV, serology lab test, and CT scan, respectively. A significant difference was found in requesting lumbosacral graph among specialties. Moreover, the priorities for nonsurgical treatment were NSAIDs, nonpharmaceutical treatment, muscle relaxants, gabapentin, and corticosteroids, respectively.
Conclusion
History taking, physical examination, diagnostic approaches, and treatments were significantly different among the different specialties. The results revealed the need for consensus on common and well-established guidelines for a clinical approach to chronic low back pain.

Keywords

References

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Reviews in Clinical Medicine
Volume 12, Issue 2
April 2025
Pages 82-88

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