Back Pain

Overview

Assessment

Retroperitoneal

Spinal

Attempt to fit neurological signs with an anatomic site - cord (anterior, posterior, central), nerve root

Incongruous or bizarre patterns are less predictive of neurological involvement

Imaging

Plain lumbar film

Indications

Management

If the pain is severe, it is more reliable to defer the examination until the pain settles

Diazepam in doses commonly employed has limited role in alleviating muscle spasm

Many failures to treatment are due to inadequate initial analgesia

Disposition

Urgent neurosurgical consultation if:

Admit if:

Discharge if:

Discharge instructions

Avoiding:

Further imaging if:

Prevention

See Handout for Back Pain