Severe low-back pain. I: Clinical assessment of two weeks conservative therapy

A standard clinical examination was performed by two independent investigators, before and after two weeks of conservative therapy, on 33 patients with severe low-back pain. Kappa coefficients indicated a higher reproducibility of neurological tests than of e.g. muscular tenderness or scoliosis. All patients were diagnosed by CT-scan and a disc herniation was found in 20. The clinical diagnosis was more in agreement with the CT-diagnosis after than before treatment. By discriminant analyses six variables were found to classify the clinical diagnosis correctly in 32 of the 33 patients: sensory loss, ankle jerk, soreness of back extensors, lumbosacral soreness, radiating pain and back extension test. Similarly, the CT-diagnosis was classified in 25 of 33 patients by the variables: sensory loss and limping.