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Extravertebral low back pain: a scoping review.
Anna Kunow1, Julia Freyer Martins Pereira2, Jean-François Chenot2
1Department of General Practice, University Medicine Greifswald, 17475, Fleischmannstraße, Greifswald, Germany. kunow.anna@web.de.
BMC Musculoskeletal Disorders
|May 7, 2024
Summary
Extravertebral causes of low back pain (LBP) are often overlooked. This review highlights rare but serious conditions, emphasizing the need for clinicians to consider atypical symptoms for accurate diagnosis.
Area of Science:
- Medical research
- Clinical diagnostics
- Pain management
Background:
- Low back pain (LBP) is a common primary care complaint.
- Current LBP classification excludes extravertebral causes like abdominal aortic aneurysm.
- Systematic investigation into these rare causes is lacking.
Purpose of the Study:
- To systematically review extravertebral causes of LBP.
- To identify potential extravertebral conditions presenting as LBP.
- To assess current guidelines and diagnostic challenges.
Main Methods:
- Systematic literature search (MEDLINE, Embase, Cochrane).
- Inclusion of studies from 2001-2020 with LBP as the primary symptom.
- Handsearch to supplement database findings.
Main Results:
- Identified 265 publications plus 197 from handsearch.
- Majority of studies were case reports/series from specialized settings.
- Extravertebral causes include gynecological, urological, vascular, systemic, and gastrointestinal diseases.
- Guidelines showed inconsistencies in addressing extravertebral LBP.
Conclusions:
- No prior systematic review on extravertebral LBP causes.
- Lack of epidemiological data and standardized protocols hinders understanding.
- Atypical symptoms like fever or abdominal pain may indicate extravertebral causes.
- Clinicians should suspect extravertebral etiologies with atypical presentations.
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