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Diagnostics
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Low Back Pain: Diagnosis and Management
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Low Back Pain: Diagnosis and Management

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Pathology and Molecular Diagnostics".

Deadline for manuscript submissions: 31 March 2025 | Viewed by 4193

Special Issue Editor

Prof. Dr. Edward Saulicz

E-Mail Website
Guest Editor
Institute of Physiotherapy and Health Sciences, Jerzy Kukuczka Academy of Physical Education, 40-065 Katowice, Poland
Interests: low back pain; kinesitherapy; musculoskeletal disorder; manual therapy; pelvic floor; core stability; tactile acuity; kinesiophobia

Special Issue Information

Dear Colleagues,

In most countries of the world, low back pain is listed among the most common causes of disability. It is estimated that the percentage of people who will experience low back pain at least once in their life exceeds 80%. Despite such a widespread prevalence of the problem, making a precise diagnosis and prescribing adequate treatment are not possible in the vast majority of cases of low back pain. In many countries, radiography, computed tomography, or magnetic resonance imaging is now a standard diagnostic procedure used by specialists to diagnose low back pain. Depending on the severity of the patient's symptoms and their duration, as well as the results of the imaging test, a decision is made to start conservative treatment, surgery, pharmacotherapy, physiotherapy, or another method of reducing pain. Unfortunately, imaging of the spine in the case of non-specific ailments most often does not explain the mechanism of pain, as evidenced by studies on groups of asymptomatic people. Current observations confirm the low diagnostic, prognostic, and differential value of spinal imaging tests in the case of common low back pain. Moreover, the overuse of these tests is expensive and increases the risk of iatrogenic complications. Another disturbing phenomenon is the cascade effect, which, in the context of health care, can be defined as a sequence of events initiated by an unnecessary test, its unexpected result, and the patient's or specialist's fear. This results in further inappropriate testing or treatment, increasing morbidity and escalating side-effects. With respect to low back pain, the cascade effect of an unjustified MRI examination also has long-term economic consequences.

This Special Issue aims to collect papers on the diagnosis and management of LBP, including but not limited to the following content:

  • Clinical diagnosis of low back pain;
  • Differential diagnosis of low back pain;
  • Diagnosis of chronic low back pain;
  • Diagnosis of nonspecific low back pain;
  • Measures of function in low back pain;
  • Clinical diagnosis of low back pain;
  • Diagnosis of sacroiliac pain;
  • Functional assessment of sacroiliac joint dysfunction;
  • Assessment of red flags in low back pain;
  • Assessment of yellow flags in low back pain;
  • Biopsychosocial model of the process of diagnosis and management of low back pain.

We look forward to your submission.

Prof. Dr. Edward Saulicz
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • clinical diagnosis
  • low back pain
  • nonspecific low back pain
  • discogenic low back pain
  • sacroiliac pain
  • sacroiliac joint dysfunction
  • assessment of red flags in low back pain
  • assessment of yellow flags in low back pain
  • biopsychosocial model

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Published Papers (5 papers)

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Research

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11 pages, 261 KiB  
Article
The Effect of Kinesiology Taping on Posture, Balance, and Gait in Patients Suffering from Low Back Pain
by Józef Alphons Opara and Tomasz Fiałkowski
Diagnostics 2024, 14(22), 2506; https://doi.org/10.3390/diagnostics14222506 - 9 Nov 2024
Viewed by 710
Abstract
Background: Low back pain (LBP) is the leading cause of lost productivity, absenteeism, disability, and early retirement worldwide. LBP treatment should be comprehensive, including prevention, education, diagnosis, and various treatment methods. Management can be divided into pharmacological and non-pharmacological. The role of physiotherapy [...] Read more.
Background: Low back pain (LBP) is the leading cause of lost productivity, absenteeism, disability, and early retirement worldwide. LBP treatment should be comprehensive, including prevention, education, diagnosis, and various treatment methods. Management can be divided into pharmacological and non-pharmacological. The role of physiotherapy in the comprehensive treatment of LBP is very important. Elastic therapeutic tape, also called kinesiology tape or therapeutic kinesiology tape, has been used for about 50 years. Purpose: The aim of this study was to evaluate the effectiveness of Kinesio taping in patients suffering from (LBP), and its possible effect on the swing of the center of pressure (COP), balance, gait, improvement of coordination, and pain reduction. Methods: A total of 60 patients aged 20 to 83 years (54% women) were examined, all of whom fulfilled the requirements for admission and rejection. The L1–L5 spine of the experimental group underwent Kinesio taping in addition to thorough rehabilitation. The control group underwent balance control training based on visual feedback (VFB). The research tools used included the Bohannon single-leg standing test, the FAC (Functional Ambulatory Category) scale, the Podsiadlo and Richardson Standing and Walking Test called “Timed Up and Go” (TUG), evaluation of lumbar spine movement, Lasegue’s test and examination of neurological deficit symptoms, and self-assessment of pain using the Visual Analog Scale (VAS). Results: The effects of Kinesio taping on pain, gait, coordination, postural control, and balance are statistically significant. The main parameter influencing the effects of Kinesio taping was age (below 55 years); this relationship was also observed in the control group. Conclusions: Kinesio taping is an effective method in the treatment of LBP. It improves postural control, balance, gait, coordination, and pain. Full article
(This article belongs to the Special Issue Low Back Pain: Diagnosis and Management)
14 pages, 649 KiB  
Article
Comparative Efficacy of Quadratus Lumborum Muscle Energy Technique with Gluteus Medius Strengthening Versus Gluteus Medius Strengthening Alone in Sacroiliac Joint Dysfunction: A Randomized Controlled Trial
by Rabail Rani Soomro, Hossein Karimi and Syed Amir Gilani
Diagnostics 2024, 14(21), 2413; https://doi.org/10.3390/diagnostics14212413 - 30 Oct 2024
Viewed by 697
Abstract
Background: Pain in the sacroiliac joint is the most prevalent and often overlooked. The sacroiliac joints are thought to be sources of pain in roughly 10% to 25% of patients with chronic lower back pain. Due to the biomechanical nature of the joint, [...] Read more.
Background: Pain in the sacroiliac joint is the most prevalent and often overlooked. The sacroiliac joints are thought to be sources of pain in roughly 10% to 25% of patients with chronic lower back pain. Due to the biomechanical nature of the joint, muscle imbalance is the most important cause of sacroiliac joint dysfunction. The hamstring and gluteus medius are the primary muscles involved in postural dysfunction-related muscle imbalance; however, the quadratus lumborum’s role in the compensatory mechanism is becoming more apparent, and its potential for treatment in conjunction with gluteus medius strengthening has not yet been investigated. Gluteus medius exercises, along with conventional treatment, are routinely given to patients with sacroiliac joint dysfunction; however, the aim of this study is to explore the additional effects of the muscle energy technique (MET) on the quadratus lumborum along with strengthening of the gluteus medius on pain, disability and quality of life of patients with sacroiliac joint dysfunction. Methods: Using a computer-generated random number table, seventy patients with unilateral sacroiliac joint pain were divided equally and randomly into two groups. Prior to initiating treatment, baseline measurements were taken using a hand-held dynamometer, visual analog scale (VAS), Oswestry Disability Index (ODI-U) and short form 36-item survey (SF-36v2) to assess strength, pain, functional disability and quality of life, respectively. Over the course of four weeks, all patients received twelve sessions, and both the pre- and post-intervention outcome measures were documented. Results: After 4 weeks of treatment, both groups showed statistically significant (p < 0.005) mean improvements in muscle strength, pain, disability and quality of life before and after intervention. However, the mean improvements in post-intervention on a dynamometer, VAS, ODI and SF-36 were better in the MET with exercise group (METGME) as compared to the conventional group with exercise (CTGME), with a larger effect size. Conclusions: The muscle energy technique, applied to the quadratus lumborum in combination with gluteus medius strengthening, is more effective clinically and significantly in improving pain, disability and quality of life in comparison to conventional treatment of sacroiliac joints with gluteus medius exercises. Full article
(This article belongs to the Special Issue Low Back Pain: Diagnosis and Management)
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12 pages, 1769 KiB  
Article
Combined Oxygen–Ozone and Porcine Injectable Collagen Therapies Boosting Efficacy in Low Back Pain and Disability
by Manuela De Pascalis, Susanna Mulas and Liliana Sgarbi
Diagnostics 2024, 14(21), 2411; https://doi.org/10.3390/diagnostics14212411 - 29 Oct 2024
Viewed by 561
Abstract
Background/Objectives: Intervertebral disc degeneration is the most common cause of low back pain (LBP), and lumbosciatica is a major challenge to healthcare systems worldwide. For years, ozone therapy has been used with excellent results in intervertebral disc disease and in patients with LBP. [...] Read more.
Background/Objectives: Intervertebral disc degeneration is the most common cause of low back pain (LBP), and lumbosciatica is a major challenge to healthcare systems worldwide. For years, ozone therapy has been used with excellent results in intervertebral disc disease and in patients with LBP. In vitro studies have demonstrated the positive action of porcine collagen in extracellular matrix remodeling and homeostasis. These tissue changes, associated with LBP, may suggest an indication for combined ozone/collagen treatment in patients with LBP. However, no studies have been reported regarding this combination of treatments. Methods: The present work compared retrospective data of two treatment groups (each of 10 LBP patients): (A) oxygen–ozone therapy (OOT) vs. (B) OOT plus porcine collagen type 1 injections (COL I). Pain intensity and physiological function were assessed by the numerical rating scale (NSR) method. The Roland–Morris questionnaire was used to assess disability. Patient data were acquired before, during, and at the six-month follow-up. Significant differences were assessed by ANOVA and Student’s t-test. Results: The analyses revealed significant statistical differences comparing the two arms, where the (OOT+COL I) treatment demonstrated a booster efficacy in pain (a reduction of 62% vs. 35%), while the questionnaire revealed a reduction in disability (70% vs. 31%). Conclusions: Therefore, this combination therapy (oxygen–ozone plus porcine injectable collagen) might be a promising approach for the management of patients with LBP. Full article
(This article belongs to the Special Issue Low Back Pain: Diagnosis and Management)
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6 pages, 199 KiB  
Communication
Comparison of Clinical Characteristics between Responders and Non-Responders to Hamstring Stretching in Individuals with Chronic Low Back Pain
by Lech Dobija, Bruno Pereira, Arnaud Dupeyron and Emmanuel Coudeyre
Diagnostics 2024, 14(19), 2117; https://doi.org/10.3390/diagnostics14192117 - 24 Sep 2024
Viewed by 553
Abstract
Background/Objectives: Hamstring muscle (HM) flexibility is frequently compromised in people with chronic low back pain (CLBP), contributing to disability and leading to a less favorable recovery. In a previous article, we presented the results of a study on the immediate effect of passive [...] Read more.
Background/Objectives: Hamstring muscle (HM) flexibility is frequently compromised in people with chronic low back pain (CLBP), contributing to disability and leading to a less favorable recovery. In a previous article, we presented the results of a study on the immediate effect of passive HM stretching on flexibility in 90 people with CLBP. There was considerable variability in the changes after stretching. The objective of this supplementary analysis was to compare the clinical characteristics of individuals who experienced a significant improvement in flexibility with those who did not. Methods: We fixed a threshold of 7° to indicate an improvement in passive Straight Leg Raise (SLR) angle and differentiate between ‘Responders’ and ‘Non-responders’ regarding passive HM stretching. Results: Only body mass index differed between groups; it was significantly smaller in Responders (p = 0.007). The majority of Non-responders experienced workplace accidents, but this was of marginal difference compared to Responders (p = 0.056). Conclusions: Further studies should consider a broader clinical analysis with a larger sample size to understand which factors influence the HM stretching response in CLBP patients. Full article
(This article belongs to the Special Issue Low Back Pain: Diagnosis and Management)

Review

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26 pages, 5246 KiB  
Review
Image-Guided Minimally Invasive Treatment Options for Degenerative Lumbar Spine Disease: A Practical Overview of Current Possibilities
by Makoto Taninokuchi Tomassoni, Lorenzo Braccischi, Mattia Russo, Francesco Adduci, Davide Calautti, Marco Girolami, Fabio Vita, Alberto Ruffilli, Marco Manzetti, Federico Ponti, George R. Matcuk, Cristina Mosconi, Luigi Cirillo, Marco Miceli and Paolo Spinnato
Diagnostics 2024, 14(11), 1147; https://doi.org/10.3390/diagnostics14111147 - 30 May 2024
Cited by 1 | Viewed by 1186
Abstract
Lumbar back pain is one of the main causes of disability around the world. Most patients will complain of back pain at least once in their lifetime. The degenerative spine is considered the main cause and is extremely common in the elderly population. [...] Read more.
Lumbar back pain is one of the main causes of disability around the world. Most patients will complain of back pain at least once in their lifetime. The degenerative spine is considered the main cause and is extremely common in the elderly population. Consequently, treatment-related costs are a major burden to the healthcare system in developed and undeveloped countries. After the failure of conservative treatments or to avoid daily chronic drug intake, invasive treatments should be suggested. In a world where many patients reject surgery and prefer minimally invasive procedures, interventional radiology is pivotal in pain management and could represent a bridge between medical therapy and surgical treatment. We herein report the different image-guided procedures that can be used to manage degenerative spine-related low back pain. Particularly, we will focus on indications, different techniques, and treatment outcomes reported in the literature. This literature review focuses on the different minimally invasive percutaneous treatments currently available, underlining the central role of radiologists having the capability to use high-end imaging technology for diagnosis and subsequent treatment, allowing a global approach, reducing unnecessary surgeries and prolonged pain-reliever drug intake with their consequent related complications, improving patients’ quality of life, and reducing the economic burden. Full article
(This article belongs to the Special Issue Low Back Pain: Diagnosis and Management)
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