Specific back pain – effective diagnosis and treatment from the radiologist’s point of view

Abstract

Background

The diagnosis and treatment of specific back pain is important in radiology. Due to the high number of patients suffering from back pain, it is important to provide excellent diagnostic and therapeutic support.

Method

Based on a recent literature search and considering the relevant guidelines as well as expert opinions, the aspects of specific back pain important for radiologists in terms of pathogenesis, diagnosis, and treatment are presented.

Results

Clinical examination in combination with the medical history provides a valid suspected diagnosis. This should subsequently be verified radiologically. MRI is the most effective cross-sectional diagnostic method for investigating specific back pain. A conventional X-ray on two planes in a standing position can be a useful addition if postural causes are suspected. If the clinical symptoms match the morphological findings, radiological treatment can be carried out for nerve root involvement as well as for inflammatory changes of the facet joints. The improvement in symptoms after radiological therapy is considered good overall; at least a short-term improvement in symptoms can generally be achieved, but no reliable data is available regarding the long-term outcome. Using preparations containing triamcinolone, low dosages should be selected in accordance with the guidelines. Embedding in a multimodal pain therapy treatment concept should be considered.

Conclusion

Radiology provides essential diagnostic findings regarding specific back pain. Interventional pain therapy is an effective and safe method of treating proven specific back pain.

Key Points

• First examine clinically, then confirm the suspected diagnosis radiologically.

• MRI is usually the method of choice.

• Interventional pain therapy should show success after a maximum of 2 interventions.

• The anti-inflammatory drug dose should be kept as low as possible.

• The individual course determines the number of interventions.

Citation Format

• Stueckle CA, Haage P. Specific back pain – effective diagnosis and treatment from the radiologist’s point of view. Fortschr Röntgenstr 2024; DOI 10.1055/a-2371-1752

Keywords

CT - interventional MR - diagnostic radiology - radiculopathy - back pain - infiltration therapy

Publikationsverlauf

Eingereicht: 14. Dezember 2023

Angenommen nach Revision: 03. Juni 2024

Artikel online veröffentlicht:
21. August 2024

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