Table 2.
Items contributing to the assessment process in general, rated as important by >70% of the participants
| Clinical assessment of low back-related leg pain in primary care | |
|---|---|
| Importance of each item rated according to its contribution to any of the following decisions: | |
| Establishing severity of symptoms | |
| Establishing need for investigations | |
| Establishing need for treatment/onwards referral | |
| Establishing the likely diagnosis | |
| Informing treatment | |
| Predicting prognosis | |
| History items | |
| Items/questions | Important (7–9 on scale) |
| Domain: pain | |
| Area or distribution of pain in the leg | 93.8% (n = 45) |
| Progression of pain in the leg since onset of current episode (e.g. better/worse/same) | 87.5% (n = 42) |
| Severity of pain in the leg compared with severity of pain in the low back | 85.4% (n = 41) |
| Progression of LBP (e.g. better/worse/same) | 83.3% (n = 35) |
| Pain intensity in the leg | 79.2% (n = 38) |
| Aggravating and easing factors for the leg pain | 77.1% (n = 37) |
| Duration of symptoms in the leg | 75% (n = 36) |
| Response of leg pain to cough/sneeze/strain | 73.8% (n = 31) |
| Quality of pain in leg (e.g. burning, sharp, tingling, etc.) | 73.8% (n = 31) |
| Domain: symptoms other than pain | |
| Altered sensation in the leg (e.g. reporting of numbness and/or pins and needles, etc.) | 83.3% (n = 40) |
| Feeling of weakness in the leg | 83.3% (n = 40) |
| Domain: previous history | |
| Effect of previous self-management | 81.0% (n = 34) |
| Effect of previous treatment for similar symptoms | 78.6% (n = 33) |
| Previous history of similar leg pain | 76.2% (n = 32) |
| Domain: function | |
| Effect of leg pain on ability to work | 83.3% (n = 40) |
| Effect of leg pain on activities of daily living | 83.3% (n = 40) |
| Effect of back pain on activities of daily living | 79.2% (n = 38) |
| Effect of back pain on ability to work | 79.2% (n = 38) |
| Effect of leg pain on ability to do leisure activities/sports | 71.4% (n = 30) |
| Domain: psychosocial factors | |
| Assessment of patient’s perceptions and beliefs pertaining to their condition | 91.7% (n = 44) |
| Assessment of patient’s coping strategies | 89.6% (n = 43) |
| Assessment of patient’s distress | 87.5% (n = 42) |
| Assessment of patient’s fear and apprehension of movement | 85.4% (n = 41) |
| Assessment of patient’s future outlook | 85.4% (n = 41) |
| Assessment of patient’s mood | 83.3% (n = 40) |
| Assessment of effect of symptoms on family situation | 79.2% (n = 38) |
| Assessment of work issues | 77.1% (n = 37) |
| Examination items | |
| Observation | |
| Muscle wasting | 85.4% (n = 41) |
| Spinal movements | |
| Demonstration of movement that produces symptoms | 71.4% (n = 30) |
| Neurological examination | |
| Assessment of muscle strength related to specific myotomes | 89.6% (n = 43) |
| Assessment of reflexes | 83.3% (n = 40) |
| SLR response on ‘well’ leg (cross-over pain) | 83.3% (n = 35) |
| Assessment of neural tension tests (SLR, femoral, slump) | 77.1% (n = 37) |
| Assessment of sensory appreciation | 72.9% (n = 35) |