A logical approach to the diagnosis of back pain

The diagnosis of back pain is a frequent problem in family practice. Although many detailed classifications are available, it is often useful simply to determine whether the back pain arises in the musculoskeletal system, the central nervous system or is referred to the back from a distant site. Careful history taking must be combined with a complete physical examination covering these three areas. A good working diagnosis requires adequate clinical information. The author describes a rapid and thorough examination technique which provides all the necessary information. A series of logical deductions leads the physician to a final diagnosis precise enough to direct further investigation, determine treatment or suggest proper referral.