Assessment
Figure 1. Initial Evaluation of LBP
Adults with LBP
Perform a focused history and physical examination, evaluating:
>> Duration of symptoms
>> Risk factors for potentially serious conditions
>> Symptoms suggesting radiculopathy or spinal stenosis
>> Presence and severity of neurologic deficits
>> Psychosocial risk factors
NO
Are any potentially serious conditions
strongly suspected?
YES
Perform diagnostic studies to
identify cause
Back pain is mild with
no substantial functional
impairment?
NO
NO
Specific cause identified?
YES
YES
Advise about self-care
Discuss noninvasive treatment options:
>> Pharmacologic
>> Nonpharmacologic
Advise about self-care
Review indications for
reassesment
Arrive at shared decision regarding therapy trial
Educate patient
Patient
accepts risks
and benefit of
therapy?
NO
Continue
self-care
Reassess in
1 month
2
YES
Patient on
therapy?
NO
Refer to
Figure 2,
LBP not on
therapy
YES
Refer to
Figure 2, LBP
on therapy
Treat specific cause
as indicated, consider
consultation
