Lumbalgia: a box of surprises

Lumbalgia is a common problem in Medicine. Usually in more than 80% of the cases is associated with a degenerative or discal problem, but in some patients is an important alarm symptom. Is there any rule to improve diagnosis in a lumbalgia associated with an important disease?

COMMENTS: There is consensus that if the lumbalgia last for less than four weeks no imaging is indicated. Then,what to do in practical terms?

The first thing is a complete anamnesis and physical examination. Details are important and the duration and pain distribution or characteristics must be clearly recorded.

Common sense and follow-up are two important aspects of the clinical assessment.

Associated signs or symptoms can be a key factor for a correct diagnosis, for instance lumbalgia and renal failure is compatible with myeloma. Fever and lumbalgia could be associated with abdominal lymphoma. Constitutional symptoms and lumbalgia could be a presentation of a neoplastic or infectious disease.