Title: Back Pain<br/>Author: Brian Corwell<br/><a href='http://umem.org/profiles/faculty/294/'>[Click to email author]</a><hr/><p>
Back pain accounts for more than 2.6 million visits</p>
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30% of ED patients receive X-rays as part of their evaluation</p>
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Imaging can be avoided in a majority of these patients by focusing on high risk (red flags) findings in the history and physical exam.</p>
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Patients who can identify a an acute inciting event without direct trauma likely have a MSK source of pain.</p>
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Imaging rarely alters management</p>
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Attempt to avoid imaging in patients with nonspecific lower back pain of less than 6 weeks duration, with a normal neurologic exam and without high risk findings (fever, cancer, IVDA, bowel or bladder incontinence, age greater than 70, saddle anesthesia, etc)</p>
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Patients with radiculopathy (sciatica) and are otherwise similar to the above also do not require emergent imaging</p>