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Evaluation of orthopedic testing of the low back for nonspecific lower back pain
1Department of Chiropractic, Osteopathy & Complementary Medicine, RMIT Melbourne, Australia.
Objective:
To assess the value of some commonly used orthopedic tests used in evaluating nonspecific lower back pain where there are no demonstrable pathological or neurological deficits.
Design:
Retrospective analysis of patient files.
Setting:
Chiropractic teaching clinic, Royal Melbourne Institute of Technology.
Subjects:
Five hundred sixty-four files of patients presenting to the above clinic with nonspecific lower back pain were analyzed.
Data Analysis:
The data were entered into a spreadsheet, contingency tables were created, and the data were analyzed using chi 2 tests. Statistical significance was set at p < .05.
Results:
Kemp's and Yeoman's tests were most commonly positive, whereas Bonnet's, supported Adams' and axial compression tests showed relatively low positive results. The factors studied that affected the rate of positive responses were age, gender, pain site, duration and cause. The number of previous episodes of lower back pain had no effect on the positive test rates.
Conclusion:
For cases of nonspecific, mechanical lower back pain, orthopedic testing has limited clinical value once nerve root problems and pathologies have been ruled out. Kemp's and Yeoman's tests were the most frequently positive, and seemed to be the most useful in diagnosing nonspecific lower back pain. When selecting the most appropriate tests to use, one needs to take into account the patient profile and history.