[Diagnosis of chronic backache in health resort patients]

Conservative treatment of backache requires an accurate diagnosis because sometimes such patients are suffering from a serious but unrecognised disease of the abdomen or low back region. Diagnoses like cervical syndrome, lumbar syndrome or even cervicodorso-lumbar syndrome are not sufficiently conclusive to start conservative treatment, since they convey nothing in respect of cause, prognosis or aim of treatment. Patients undergoing a course of inpatient curative treatment of, say, four weeks in a hospital, need special therapy programmes that are meaningfully based on precise data on their disorder. It is important to set great store by the physical examination (which is often performed cursorily before the patients are referred to curative inpatients treatment), including a neurological examination and in some cases also EMG, special radiographs, myelography, CT, magnetic resonance imaging and the like to gather more information on the real cause of the low back pain. This will also help the physician in arriving at a fair estimation of the patient's performance rating. A useful classification of patients into two groups would be as follows: a) without neurological symptoms, and b) with signs of a nerve-root compression or even spinal cord symptoms.