A more precise diagnosis for low-back pain.

Five common syndromes productive of low-back and leg pain are presented as the basis for clinical investigation to arrive at an early and definite diagnosis in low-back pain problems. The five are posterior facet syndromes, sacroiliac-piriformis syndrome, herniated nucleus pulposus, central spinal stenosis, and nerve entrapment in the lateral recess. All may present with a common symptom complex of low-back, buttock, trochanteric, and posterior thigh pain. Specific details from history, physical, and radiographic examination may allow separation of these entities, but proof of diagnosis requires data from response to treatment, facet and nerve injection, myelography, discography, and computerized tomography (CT) scan.