Evaluation of the peripheral nervous system in disability management: practical aspects in lower back pain

Lower back pain (LBP) is a common condition with profound economic and social consequences. A conservative, symptomatic, goal-oriented management program is advocated by most, emphasizing pain relief and restoration of functional capacity. Still, LBP is recurrent in approximately 50% of patients and up to 5-10% experience chronic intractable pain. This article describes how to evaluate and rehabilitate the patient with spinal impairment (SI). All is summarized in a diagnostic/treatment algorithm as used in the spine rehabilitation center. Causes of LBP, components of the patient history and physical, diagnostic test usage and management options are summarized in tables for future reference. Lastly, preventative measures are discussed which, when implemented within a treatment program, may prevent future reoccurrences.