Conclusions For most clinical tests in LBP there is not consistent evidence for an association with outcome .
Central ization and non-organic signs are exceptions from that .
Background There is a strong tradition of performing a clinical examination of low back pain ( LBP ) patients and this is generally recommended in guidelines .
However , establishing a pathoanatomic diagnosis does not seem possible in most LBP patients and clinical tests may potentially be more relevant as prognostic factors .
The aim of this review of the literature was to systematic ally assess the association between low-tech clinical tests commonly used in adult patients with acute , recurrent or chronic LBP and short- and long-term outcome .
Predictors of a favorable response to transforaminal injection of steroids in patients with lumbar radicular pain due to disc herniation.
BACKGROUND Transforaminal injection of steroids ( TFIS ) is effective for some patients with lumbar radicular pain caused by disc herniation . Factors associated with better outcomes are unknown . OBJECTIVE To identify clinical and radiological features predictive of a favorable response to TFIS . METHODS Seventy-one patients with lumbar radicular pain caused by disc herniation were treated with TFIS as part of a previously reported , r and omized , clinical trial . The clinical features analyzed were the presence of neurologic symptom , neurologic signs , and the duration of sciatica . Radiological features evaluated using magnetic resonance imaging ( MRI ) were the segmental level of the pathology , the location and morphological features of the disc herniation , the cross-sectional area of the disc herniation and its ratio to the cross-sectional area of the spinal canal , and the grade of nerve root compression . RESULTS None of the clinical features was associated with successful outcome from treatment . The only radiological feature associated with successful outcome was the grade of nerve root compression . Of patients with low- grade root compression , 75 % responded favorably to TFIS . Only 26 % of patients with high- grade nerve root compression responded . DISCUSSION These results indicate that  TFIS  is more often successful in patients without significant compression of the nerve root and , therefore , in whom an inflammatory basis for radicular pain is most likely . In such patients , a success rate of 75 % renders TFIS an attractive alternative to surgery . In patients with significant compression of the nerve root , the likelihood of benefiting from TFIS is low . The success rate may be no more than that of a placebo effect , and surgery may be a more appropriate consideration
Conclusions For most clinical tests in LBP there is not consistent evidence for an association with outcome .
Central ization and non-organic signs are exceptions from that .
Background There is a strong tradition of performing a clinical examination of low back pain ( LBP ) patients and this is generally recommended in guidelines .
However , establishing a pathoanatomic diagnosis does not seem possible in most LBP patients and clinical tests may potentially be more relevant as prognostic factors .
The aim of this review of the literature was to systematic ally assess the association between low-tech clinical tests commonly used in adult patients with acute , recurrent or chronic LBP and short- and long-term outcome .