Red flag screening for low back pain: nothing to see here, move along: a narrative review
Despite intense focus and increased research funding, the self-reported levels of disability in individuals with low back pain (LBP) have not improved in the last decade. Worsening disability has propagated, despite the presence of numerous classification schemes designed to lead to patient-specific treatments. The care provided to patients frequently does not meet professionally recommended standards. We can do much better. We have to do better.
Diagnosis is one of many necessary components during the clinical decision-making process. Characteristically, diagnosis is performed early in the management process of the patient and involves both soft skills (clinical reasoning) and highly valid quantitative clinical testing methods. All medical professionals who manage LBP, regardless of training, background or philosophy, use differential diagnostic methods to improve the likelihood of providing the right care to the appropriate patient and reducing risks associated with delayed management. By its nature, differential diagnosis is a systematic process used to identify the proper diagnosis from a competing set of possible diagnoses. For example, a practitioner would perform more extensive diagnostic testing for an individual with LBP that also has clinical indication of cancer or infection compared with one without those indicators.