What is the algorithm for the diagnosis and management of low back pain (LBP) and sciatica?

Updated: Aug 22, 2018
  • Author: Jasvinder Chawla, MD, MBA; Chief Editor: Stephen A Berman, MD, PhD, MBA  more...
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Answer

Answer

When leg pain predominates and imaging studies provide ambiguous information, clarification may be gained by performing electromyography (EMG), somatosensory evoked potential (SSEP) testing, or selective nerve root blocks. When the cause of sciatica is related to neural compression by bony or soft-tissue structures in the spinal canal, a surgical consultation should be considered. If the results of the diagnostic information are inadequate to explain the degree of neurological deficit, pain, and disability, a multidisciplinary evaluation may provide insight into the perpetuating physical and psychosocial factors (see image below).

Algorithm for the management of low back pain and Algorithm for the management of low back pain and sciatica.

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