Physical exam and medical history

							MADRID. - Patients with lumbago ask radiography, some
doctors opt for physiotherapy and others, back schools ...
Although back pain is one of the most common problems, there
are many uncertainties about what are the best tools to diagnose
and treat. The American College of Physicians, in collaboration
with the American Pain Society, just reviewed the available
evidence on this ailment. Their findings, published in the journal
Annals of Internal Medicine, are summarized in seven tips.

 .Physical exam and medical history
 %58of low back pain can not be attributed to a specific disease
or abnormality (the so called non-specific back pain). When the
query reaches a patient with low back pain, always take a
medical history and physical examination to determine if the
pain is non-specific cause or could be due to a serious problem
like cancer, a fracture or a herniated disc. "No evidence suggests
that labeling most patients with low back pain using specific
diagnostic tools improves outcomes," say the authors, who do
recommend, however, study or social psychological factors
(depression, job dissatisfaction ...) that could delay recovery.

 .No to the imaging
In general, patients with low back pain should not undergo
imaging tests or other diagnostic tools. Not contribute to the
affected evolve better and, on the contrary, he unnecessarily
subjected to a considerable amount of radiation or other
discomfort. A plain radiograph of the spine equals a chest
radiograph performed daily for over a year. X-rays are
recommended only when suspected the patient may have a
vertebral fracture. The newer tests (CT and MRI) are also not
advisable in these cases: minor anomalies often find that,
although they are not the cause of pain may lead to unnecessary
interventions.