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Uploaded byDaradia: The Pain Clinic
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Back Pain Evaluation: Red Flags, Neurological Examination & Special Tests | Step-by-Step Guide

A structured, practical guide to clinical evaluation of low back pain for physicians and pain specialists. This presentation covers: • Red flags in back pain • Targeted history taking • Physical and neurological examination • Straight Leg Raise (SLR) / Lasègue test • Spinal stenosis assessment • Sacroiliac joint provocation tests • Piriformis and deep gluteal pain tests Designed for daily outpatient practice, postgraduate training, and interventional pain medicine decision-making. 👉 Full detailed guide available here: https://daradia.com/back-pain-evaluation-red-flags-examination-tests/ Created by Daradia – The Pain Clinic (India)

Health & Medicine◦
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Evaluation of Patients of Back Pain
Steps of evaluation
1 Causes & Red flags 2 History •General History •Specific History 3 Examination •General •Inspection •Palpation •Range of movement •Neurological examination •Special tests 4 Investigations •Image (X-ray/ CT/ MRI) •Blood investigations 5 Diagnostic interventions •Nerve block •Joint inj •Trigger point inj
Causes of Back Pain & Red Flags
Pain Generators for Back Pain
Red flags
• Major trauma • Suspected tumor • Suspected infection • Suspected fracture • Neuro-deficits 1. Autonomic 2. Motor 3. Sensory • SEVERE PAIN ???
Chief complain/s H/O Present illness Intensity Quality Aggravating & relieving factors Diurnal variation Family history Medical history Personal history Occupational history General history
Examination steps 1 st step Inspection 2 nd step Palpation 3 rd step Range of movements 4 th step 5 th step Neurological examinations Special tests
Inspection Posture Gait Muscle size, shape & contour Back & limb colour, swelling, scar
Palpation Tenderness • Joints • Bursa • Ligaments • Muscles & tendons
Range of movements Hip & spine Flexion Extension Rotation Lat flexion of spine Abduction/ adduction of hip
Neurological examination Higher functions & cranial nerve exam Examination of both upper & lower limbs Sensory Motor: Power, superficial & deep reflexes
Special tests Tests for lumber nerve root irritations Tests for spinal canal stenosis Tests for SI joint pain Tests for Piriformis MPS
Tests for lumber nerve irritations: Lasegue SLR test
Tests for spinal canal stenosis Stoop test Kemp test
Tests for SI joint pain Distraction test Thigh trust test Gaenslen’s test Compression test FABER test Sacral thrust
Tests for Piriformis MPS Freiberg’s maneuver FAIR test in lateral position The Beatty test