Indications of neurophysiological studies in lower back pain

Between 60% and 90% of people in developed countries experience lower back pain at some time in their life and it is therefore one of the most frequent reasons for visiting the specialist in neurology. On many occasions there is no correlation between the symptoms, the clinical pathology and the radiological features. AIM. To determine suitable indications and the appropriate time to conduct neurophysiological studies in lower back pain. We review the neurophysiological techniques that are most commonly used today and the most frequent findings in patients with acute, subacute or chronic lower back pain, and acute or chronic lumbar-radicular pain. There is no scientific evidence to prove that neurophysiological studies provide information that modifies the conservative treatment that must be established in patients with acute, subacute or chronic lower back pain, and acute lumbar-radicular pain. In patients with subacute or chronic lumbar-radicular pain, the first neurophysiological studies must be conducted between three weeks and six months after the onset of symptoms. Electromyography is the most sensitive neurophysiological test. Neurophysiological studies are carried out provided that their findings involve changes in the patient's therapeutic attitude, in the pre-operative evaluation and to confirm the extent of injury; they therefore offer prognostic data.