Revisiting the diagnostic classification for low back pain

Published on March 3, 2026

BMJ. 2026 Mar 2;392:s353. doi: 10.1136/bmj.s353.

Greater recognition of “non-spine” causes and impact on urgency of care escalation is needed

Low back pain guidelines have advocated essentially the same simple diagnostic classification as standard of practice for the past 30 years. Most guidelines recommend classifying patients presenting with a complaint of low back pain into one of three categories: non-specific low back pain (when the precise underlying cause cannot be identified), radicular syndromes, or serious pathology. Some guidelines endorse an even simpler two-category approach that classifies presentation as either low back pain with or without radicular pain, or serious pathology. Despite its long use, this approach has several limitations and may be too simplistic to guide satisfactory diagnostic work-up

PMID:41771650 | DOI:10.1136/bmj.s353

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