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Controversies in Internal Medicine
July 8, 2002

Diagnostic Evaluation of LBP: Reaching a Specific Diagnosis Is Often Impossible

Arch Intern Med. 2002;162(13):1444-1447. doi:10.1001/archinte.162.13.1444

THE DISEASE management paradigm that has served medicine so well involves making a specific diagnosis of anatomic or physiologic derangements and selecting specific therapies that address them. Thus, we have moved away from empirically treating symptoms to modifying pathophysiologic conditions. Unfortunately, this paradigm often fails us in the patient with LBP because the precise cause remains unclear in most cases. Anatomic abnormalities can be readily identified by imaging studies, but most of these abnormalities are common even in healthy people. Thus, finding a cause for LBP is often difficult or impossible.

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