Low Back Pain
What Is It?
The most common musculoskeletal complaint. Majority is non-specific mechanical low back pain. Red flags suggest serious pathology (fracture, malignancy, infection, cauda equina syndrome).
How Is It Diagnosed?
Clinical history and exam. X-ray or MRI if red flags present (new pain in patient >50, history of cancer, fever, neurological deficits, or trauma). CT myelography if MRI contraindicated.
How Is It Treated?
Acute: NSAIDs, heat, activity as tolerated, avoid bed rest. Muscle relaxants (cyclobenzaprine) for severe spasm. Chronic: physical therapy, CBT, exercise, duloxetine, tramadol if needed. Avoid opioids for non-specific LBP.
Tests and Imaging Typically Needed
Clinical diagnosis primarily. X-ray (limited utility). MRI lumbar spine if radiculopathy or red flags. CBC, ESR, CRP if infection suspected.
Approximate Self-Pay Costs
Office visit: $95-$150. X-ray: $75-$150. MRI lumbar: $500-$1,200. Physical therapy: varies.