Hegmann, Kurt T., MD
Journal of Occupational and Environmental Medicine: April 2019 – Volume 61 – Issue 4 – p e155–e168
doi: 10.1097/JOM.0000000000001551
ACOEM PRACTICE GUIDELINE
Objective: The aim of this study was to summarize evidence-based diagnostic guidelines for low back disorders.
Methods: A comprehensive literature review was conducted. A total of 101 articles of high or moderate quality addressing low back disorders diagnostic evaluation met the inclusion criteria. Evidence-based recommendations were developed and graded from (A) to (C) in favor and against the specific diagnostic test, with (A) level having the highest quality body of literature. Expert consensus was employed for insufficient evidence (I) to develop consensus guidance.
Results: Recommendations are given for these diagnostic tests: functional capacity evaluations, roentgenograms (x-rays), magnetic resonance imaging (MRI), computerized tomography, myelography, bone scans, single proton emission computed tomography, electromyography, surface electromyography, ultrasound, thermography, fluoroscopy, videofluoroscopy, lumbar discography, MRI discography, and myeloscopy.
Conclusion: Diagnostic testing is not indicated for the majority of patients with low back pain.