The Chinese Association for the Study of Pain (CASP): Consensus on the Assessment and Management of Chronic Nonspecific Low Back Pain

Table 1

Differential diagnosis for nonspecific LBP.

Possible cause	Symptoms and physical examination	Imaging test	Laboratory test
Cancer	History of cancer, unexplained weight loss, and age >50 years	Lumbosacral plain radiography and MRI	ESR and tumor marker
Vertebral infection	Fever, history of recent infection, and tuberculosis	MRI	ESR, CRP, PPD, or PCT
Syndrome of cauda equina	Urinary retention, fecal incontinence, sensory disorder in saddle area, and motor deficits	MRI	None
Vertebral compression fracture	Older age, osteoporosis, and use of corticosteroids	Lumbosacral plain radiography, BMD and MRI	None
Ankylosing spondylitis	Morning stiffness, improvement after exercises, nocturnal pain, and younger age	Pelvis plain radiography	ESR, CRP, and HLA-B27
Radiculopathy	Progressive symptoms and motor weakness	CT or MRI	EMG and NCV
Symptomatic lumbar disc herniation	Back pain with leg pain in the distribution area of nerve root L4, L5, or S1; Positive for straight-leg-raise test; Radicular pain present >1 month	None	None
Spinal stenosis	Older age, walking and standing worsen the symptom, pain relieved by sitting	CT or MRI	None