Idiopathic Low Back Pain: Classification and Differential Diagnosis

SUMMARY

Objectives: To present a contemporary view of the epidemiology, classification, and differential diagnosis of low back pain.

Findings: With age, the normal back will exhibit visible morphological changes. Thus, idiopathic low back pain cannot be directly related to the morphological picture, but is influenced by many factors related to ligaments, discs, muscles and nerves. Idiopathic low back pain is experienced in about two-thirds of the population over their life time and about half of the adult population will suffer from back pain at some time during a 12 months period. The cost to society for work absenteeism related to back pain is very high. There are a variety of systems for classifying back pain which do not always overlap, and which have different aims. The process of diagnosing back pain consists of clinical examination, various types of imaging, and laboratory tests. Imaging methods have improved greatly. For example, imaging can identify disc related problems, so patients with those lesions can be excluded from the idiopathic low back pain group. Despite improved methods, however, it is usually difficult to specify the cause of the low back pain, and it is still impossible to accurately perceive its severity.

Conclusions: Although acute back pain is often viewed as a benign and reversible condition, it can develop into a chronic condition if not correctly diagnosed and treated accordingly.

KEYWORDS:

• Idiopathic low back pain
• myofascial pain
• fibromyalgia
• muscle fatigue
• pelvic pain