Abstract
The first step in diagnosing sciatica and radicular pain is assessing the patient’s clinical history, wherein the focus is on identifying so-called ‘red flags’, which may indicate an increased risk of serious pathology. A herniated disc is such a dominant reason for radiculopathic pain that all other possibly serious spinal pathologies should be ruled out [1].
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References
Mens JMA, Chavannes AW, Koes BW, et al. NHG-Standaard lumbosacraal radiculair syndroom [NHG Guideline on lumbosacral radicular syndrome]. Huisarts Wetenschap. 2005;48:171-178.
Maughan EF, Lewis JS. Outcome measures in chronic low back pain. Eur Spine J. 2010;19:1484-1494.
Sriwatanakul K, Kelvie W, Lasagna L, et al. Studies with different types of visual analog scales for measurement of pain. Clin Pharmacol Ther. 1983;34:234-239.
von Korff M, Jensen MP, Karoly P. Assessing global pain severity by self-report in clinical and health services research. Spine. 2000;25:3140-3151.
Andersson GB. Diagnostic considerations in patients with back pain. Phys Med Rehab Clin N Am. 1998;9:309-322.
Smeal WL, Tyburski M, Alleva J. Discogenic/radicular pain. Dis Mon. 2004;50:636-669.
Miranda H, Viikari-Juntura E, Martikainen R, et al. Individual factors, occupational loading, and physical exercise as predictors of sciatic pain. Spine. 2002;27:1102-1109.
Deyo RA, Loeser JD, Bigos SJ. Herniated lumbar intervertebral disk. Ann Intern Med. 1990;15:598-603.
Picavet HS, Schouten JS. Physical load in daily life and low back problems in the general population: the MORGEN study. Prev Med. 2000;31:506-512.
Vroomen PC, de Krom MC, Knottnerus JA. Diagnostic value of history and physical examination in patients suspected of sciatica due to disc herniation: a systematic review. J Neurol. 1999;246:899-906.
Waddell G. The Back Pain Revolution. Edinburgh, UK: Churchill Livingstone; 1999.
van den Hoogen HM, Koes BW, van Eijk JT, Bouter LM. On the accuracy of history, physical examination, and erythrocyte sedimentation rate in diagnosing low back pain in general practice. A criteria-based review of the literature. Spine. 1995;20:318-327.
Agency for Health Care Policy and Research. Quick Reference Guide Number 14: Acute low back problems in adults: assessment and treatment. Available at: www.ncbi.nlm.nih.gov/books/NBK52134/. Accessed August 23, 2012.
Merskey H, Bogduk N. Classification of Chronic Pain. 2nd edn. Seattle, WA: IASP Press; 1994.
Harstall C, Ospina M. How prevalent is chronic pain? IASP Pain: Clinical Updates 2003;11:1-4.
Ostelo RWJG, de Vet HCW, Knol DL, van den Brandt PA. 24-item Roland Morris Disability Questionnaire was preferred out of six functional status questionnaires for post-lumbar disc surgery. J Clin Epidemiol. 2004;57:268-276.
Beurskens AJ, de Vet HC, Koke AJ. Responsiveness of functional status in low back pain: a comparison of different instruments. Pain. 1996;65:71-76.
Cruccu G, Anand P, Attal N, et al. EFNS guidelines on neuropathic pain assessment. Eur J Neur 2004;11: 13-62.
Haanpää, ML, Backonja MM, Bennet MI, et al. Assessment of neuropathic pain in primary care. Am J Medicine 2009;122:S13–S21.
Bennett M. The LANSS Pain Scale: the Leeds assessment of neuropathic symptoms and signs. Pain. 2001;92:147-157.
Bouhassira D, Attal N, Alchaar H, et al. Comparison of pain syndromes associated with nervous or somatic lesions and development of a new neuropathic pain diagnostic questionnaire (DN4). Pain. 2005;114:29-36.
Freynhagen R, Baron R, Gockel U, Tölle TR. painDETECT: a new screening questionnaire to identify neuropathic components in patients with back pain. Curr Med Res Opin. 2006;22:1911-1920.
Chou R, Qaseem A, Snow V, et al. Diagnosis and treatment of low back pain: a joint clinical practice guideline from the American College of Physicians and the American Pain Society. Ann Intern Med. 2007;147:478-491.
Lauder TD. Physical examination signs, clinical symptoms, and their relationship to electrodiagnostic findings and the presence of radiculopathy. Phys Med Rehab Clin N Am. 2002;13:451-467.
Devillé WL, van der Windt DA, Dzaferagić A, Bezemer PD, Bouter LM. The test of Lasègue: systematic review of the accuracy in diagnosing herniated discs. Spine. 2000;25:1140-1147.
Saal JA. Natural history and nonoperative treatment of lumbar disc herniation. Spine. 1996;21:2S-9S.
Kortelainen P, Puranen J, Koivisto E, Lähde S. Symptoms and signs of sciatica and their relation to the localization of the lumbar disc herniation. Spine. 1985;10:88-92.
Clarkson HM. Musculoskeletal Assessment: Joint Range of Motion and Manual Muscle Strength. Philadelphia: Lippincott Williams & Wilkins; 2000.
de Graaf I, Prak A, Bierma-Zeinstra S, Thomas S, Peul W, Koes B. Diagnosis of lumbar spinal stenosis: a systematic review of the accuracy of diagnostic tests. Spine. 2006;31:1168-1176.
Vroomen PC, de Krom MC, Knottnerus JA. Consistency of history taking and physical examination in patients with suspected lumbar nerve root involvement. Spine. 2000;25:91-96.
Valat JP, Genevay S, Marty M, Rozenberg S, Koes B. Sciatica. Best Pract Res Clin Rheumatol. 2010;24:241-252.
Rudwaleit M, Metter A, Listing J, Sieper J, Braun J. Inflammatory back pain in ankylosing spondylitis: a reassessment of the clinical history for application as classification and diagnostic criteria. Arthritis Rheum. 2006;54:569-578.
Mansour M, Cheema GS, Naguwa SM, et al. Ankylosing spondylitis: a contemporary perspective on diagnosis and treatment. Semin Arthritis Rheum. 2007;36:210-223.
Deyo RA, Diehl AK. Cancer as a cause of back pain: frequency, clinical presentation, and diagnostic strategies. J Gen Intern Med. 1988;3:230-238.
van Tulder M, Becker A, Bekkering T, et al. European guidelines for the management of acute non-specific low back pain in primary care. Eur Spine J. 2006;15:S169-S191.
Koes BW, van Tulder MW, Thomas S. Diagnosis and treatment of low back pain. BMJ. 2006;17:1430-1434.
NICE Clinical Guideline 88. Low back pain: early management of persistent non-specific low back pain. 2009. Available at http://publications.nice.org.uk/low-back-pain-cg88. Accessed August 23, 2012.
Hagen KB, Hilde G, Jamtvedt G, Winnem MF. The Cochrane review of bed rest for acute low back pain and sciatica. Spine. 2000;25:2932-2939.
Kendrick D, Fielding K, Bentley E, Miller P, Kerslake R, Pringle M. The role of radiography in primary care patients with low back pain of at least 6 weeks duration: a randomized (unblinded) controlled trial. Health Technol Assess. 2001;5:1-69.
Kendrick D, Fielding K, Bentley E, Kerslake R, Miller P, Pringle M. Radiography of the lumbar spine in primary care patients with low back pain: randomised controlled trial. BMJ. 2001;322:400-405.
Deyo RA, Diehl AK, Rosenthal M. Reducing roentgenography use. Can patient expectations be altered? Arch Intern Med. 1987;147:141-145.
Jarvik JG. Imaging of adults with low back pain in the primary care setting. Neuroimaging Clin N Am. 2003;13:293-305.
Gilbert FJ, Grant AM, Gillan MG, et al. Scottish Back Trial Group. low back pain: influence of early MR imaging or CT on treatment and outcome–multicenter randomized trial. Radiology. 2004;231:343-351.
Jarvik JG, Hollingworth W, Martin B, et al. Rapid magnetic resonance imaging vs radiographs for patients with low back pain: a randomized controlled trial. JAMA. 2003;289:2810-2818.
Buirski G, Silberstein M. The symptomatic lumbar disc in patients with low-back pain. Magnetic resonance imaging appearances in both a symptomatic and control population. Spine. 1993;18:1808-1811.
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Vos, K. (2013). How Are the Radiculopathies Diagnosed?. In: Laroche, F., Perrot, S. (eds) Managing Sciatica and Radicular Pain in Primary Care Practice. Springer Healthcare, Tarporley. https://doi.org/10.1007/978-1-907673-56-6_4
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DOI: https://doi.org/10.1007/978-1-907673-56-6_4
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