II. Symptoms: Low Back Pain Timing

  1. Duration
    1. Acute Low Back Pain onset within 3 months
    2. Chronic Low Back Pain persistent beyond 3 months
  2. Follows Trauma, bending, or lifting
    1. Suggests Lumbar Disc Disease
  3. Morning back stiffness with pain and onset before age 40 years
    1. Suggests Spondyloarthropathy
  4. Age of onset
    1. Age under 20 years
      1. Diskitis
      2. Vertebral Metastases
      3. Scoliosis
      4. Pyelonephritis
      5. Sickle Cell Anemia
      6. Slipped Vertebral apophysis
    2. Age under 20 years: Athletes
      1. Spondylolysis (with risk of Spondylolisthesis)
      2. Vertebral Stress Fracture
      3. Hyperlordosis
    3. Age 20 to 50 years old
      1. Lumbar strain or sprain
      2. Lumbar Disc Disease
      3. Lumbar Spinal Stenosis
      4. Spondyloarthropathy
      5. Genitourinary causes (e.g. Pyelonephritis, Nephrolithiasis, Endometriosis, Pelvic Inflammatory Disease)
      6. Gastrointestinal causes (e.g. Cholecystitis, Peptic Ulcer Disease, Pancreatitis)
    4. Age over 50 years
      1. Vertebral Compression Fracture
      2. Spinal stenosis
      3. Spondylosis
      4. Vertebral Metastases
      5. Vertebral Diskitis or Vertebral Osteomyelitis
      6. Abdominal Aortic Aneurysm
      7. Herpes Zoster

III. Symptoms: Low Back Pain Location and Radiation

  1. Dermatomal
    1. Herpes Zoster
  2. Spine
    1. Midline (especially with Vertebral tenderness and limited range of motion suggests )
      1. Vertebral disorder
        1. Traumatic Vertebral Fracture (major Trauma)
        2. Compression Fracture
        3. Vertebral metastases
        4. Vertebral Osteomyelitis
      2. Disc disorder
        1. Herniated Disc
        2. Vertebral diskiitis
    2. Sacroiliac Joint
      1. Sacroiliac Joint Dysfunction
      2. Spondyloarthropathy
    3. Paraspinous or lateral low back
      1. Lumbar strain or lumbar sprain
  3. Abdomen
    1. Epigastrium and upper quadrants radiating to upper portion of the low back
      1. Peptic Ulcer Disease
      2. Pancreatitis
      3. Cholecystitis
      4. Constipation
    2. Unilateral Abdominal Pain radiating to flank
      1. Nephrolithiasis
      2. Pyelonephritis
    3. Periumbilical Abdominal Pain radiating to midline of low back
      1. Abdominal Aortic Aneurysm
  4. Buttock
    1. Piriformis Syndrome
    2. Sacroiliac Joint Dysfunction
    3. Pilonidal Cyst
    4. Perirectal Abscess
  5. Leg
    1. Vertebral levels L1 to L3 radiates to hip and thigh
    2. Vertebral levels L4 to L5 radiate below the knee
      1. Radiation below knee is most specific for Herniated disc

IV. Symptoms: Low Back Pain Provocation

  1. Prolonged sitting provokes pain
    1. Lumbar Disc Disease
    2. Spondylosis (disc pain)
  2. Valsalva (cough, sneeze, or straining) provokes pain
    1. Lumbar Disc Disease
  3. Hyperextension provokes pain
    1. Spondylolisthesis
    2. Spondylolysis
    3. Spondylosis (facet pain)
    4. Sacroiliac Joint Disease
  4. Standing or Walking
    1. Lumbar Spinal Stenosis
      1. Pseudoclaudication with pain radiating into legs
    2. Spondylolisthesis
    3. Spondylosis (facet pain)

V. Symptoms: Low Back Pain Palliation

  1. Rest (relative or complete?)
    1. Lumbar Strain or sprain
  2. Ice or heat?
  3. Medications?
  4. Lying with knees flexed relieves pain
    1. Lumbar Disc Disease
    2. Spondylolisthesis
  5. Sitting relieves pain
    1. Lumbar Spinal Stenosis

Images: Related links to external sites (from Bing)

Related Studies

Ontology: Low Back Pain (C0024031)

Definition (MSH) Acute or chronic pain in the lumbar or sacral regions, which may be associated with musculo-ligamentous SPRAINS AND STRAINS; INTERVERTEBRAL DISK DISPLACEMENT; and other conditions.
Definition (AOT) see:http://www.nlm.nih.gov/mesh/MBrowser.html
Concepts Sign or Symptom (T184)
MSH D017116
ICD9 724.2
ICD10 M54.5
SnomedCT 156651006, 268083007, 202793005, 156648004, 40709005, 139421003, 267169009, 279039007
English Back Pain, Low, Back Pains, Low, Low Back Pains, Lumbago, Low Back Ache, Low Backache, Lower Back Pain, Ache, Low Back, Aches, Low Back, Back Ache, Low, Back Aches, Low, Back Pain, Lower, Back Pains, Lower, Backache, Low, Backaches, Low, Low Back Aches, Low Backaches, Lower Back Pains, Pain, Lower Back, Pains, Lower Back, LUMBAR PAIN, Pain, Low Back, Pains, Low Back, Nonspecific pain lumbar region, low back pain (symptom), lower back pain, lumbago (diagnosis), lumbar back pain, lumbar pain, lumbago, low back pain, Low back ache, Lumbago NOS, Low Back Pain [Disease/Finding], lumbalgia, Pain;back low, Pain;back;lumbar, low backache, low back pains, lower back pains, lumbar pains, Lower back pain, LBP - low back pain, Low back pain (disorder), Lumbago (disorder), backache lower, lower backache (diagnosis), lower backache, Low back pain, Low back syndrome, Lumbalgia, LBP - Low back pain, Nonspecific pain in the lumbar region, Lumbar pain, back; pain, low, backache; low, low back; pain, low; backache, pain; back, low, pain; low back, syndrome; low back, Lumbago (disorder) [Ambiguous], Low back pain (finding), Low Back Pain
Portuguese DOR LOMBAR, Moinha lombar, Dor lombar, Lombalgia, Dor Lombar, Lumbago
Dutch lumbago, pijn in de onderrug, lage rugpijn, lumbaalpijn, laag; rugpijn, lage rug; pijn, pijn; lage rug, pijn; onderste deel van rug, pijn; rug, laag, rug; pijn, laag, rugpijn; laag, syndroom; lage rug, Lage rugpijn, Lagerugpijn, Lumbago, Pijn, lagerug-
French Endolorissement de la région lombaire, Douleur dans la partie inférieure du dos, Douleur lombosacrale, DOULEUR LOMBAIRE, Douleur dorsale basse, Douleur lombaire basse, Douleur du bas du dos, Rachialgie lombo-sacrale, Rachialgie lombo-sacrée, Rachialgie lombosacrale, Rachialgie lombosacrée, Rachialgie lombaire, Lombalgie, Lumbago, Douleur lombaire, Douleur lombosacrée
German unterer Rueckenschmerz, unterer Rueckenschmerzen, lumbaler Schmerz, Kreuzschmerz, SCHMERZ LENDENGEGEND, Kreuzschmerzen, Lumbago, Lumbalsyndrom, Hexenschuß
Italian Dolore dorso-lombare, Lombalgia, Lombaggine, Dolore lombare
Spanish Dolor de la parte baja de la espalda, Dolor lumbar, dolor de espalda, LUMBAR, DOLOR, lumbalgia (trastorno), síndrome de dolor en la región inferior de la espalda, Lumbalgia, dolor inespecífico en la región lumbar, dolor lumbar, lumbago, lumbalgia (concepto no activo), lumbalgia (hallazgo), lumbalgia, Lumbago, Dolor de la Región Lumbar
Swedish Ländryggssmärta
Japanese ヨウツウショウ, ヨウツウ, 腰痛, 腰痛症
Czech lumbalgie, bolest v kříži, lumbago, Bolest dolní poloviny zad, Bederní bolest, Lumbago, ústřel, bolest bederní páteře, bolesti bederní páteře, bederní bolest
Finnish Alaselkäkipu
Korean 아래허리통증
Polish Ból krzyża, Ból dolnego odcinka kręgosłupa, Lumbago, Ból okolicy lędźwiowo-krzyżowej
Hungarian Lumbago, Alsó háti fájdalom, derékfájás, Derékfájdalom, Lumbalis fájdalom
Norwegian Lumbago, Hekseskudd, Korsryggssmerter