What can the history and physical examination tell us about low back pain?

A careful history and physical examination can determine the cause of pain, whether surgery will be required to relieve it and whether the patient has any psychological problems that may interfere with treatment. Low back pain is the second most common reason for patient office visits. Though 70% of adults have suffered from low back pain, it seldom lasts more than two weeks. Up to 85% of patients with low back pain cannot be precisely diagnosed because symptoms, physiological changes and imaging results do not correlate. An X-ray is no longer recommended for every patient because it does not always contribute to the diagnosis, and exposes the patient to gonadal irradiation. It is recommended only if there is evidence of a neurologic disorder, in patients over age 50 or under age 20, and in patients with fever, trauma or signs of cancer.