Standardized Physical Examination Protocol for Low Back Disorders: Feasibility of Use and Validity of Symptoms and Signs

A standardized examination protocol was developed for the assessment of low back disorders in primary care. The protocol was found feasible in the occupational health service setting. The interexaminer repeatability between an occupational physician and an occupational physiotherapist was good for most items. The predictive validity of different symptoms and signs was investigated with regard to future sick leaves due to low back disorders. Relief of pain when lying, severe trouble at work caused by pain, continuous pain, and pain in the leg or numbness or diminished sensitivity in the foot predicted sick leaves. Of physical signs, pain in the low back or buttock during lateral flexion and a side difference ≥20° in the straight-leg-raising angle were predictors for sick leaves. The predictive validity of the protocol items should be tested in another patient population before conclusions can be drawn concerning the external validity of our results.