Overview
Radiculitis, particularly in the context of low back pain, is a common condition in the United States, contributing significantly to disability 1. It is often a benign, self-limited condition 1.Diagnosis
Imaging is generally not warranted for uncomplicated acute low back pain and/or radiculopathy 1.
Imaging should be considered for patients with little or no improvement after 6 weeks of medical management and physical therapy 1.
Imaging is also indicated for patients presenting with red flags suggestive of serious underlying conditions, such as cauda equina syndrome, malignancy, fracture, or infection 1.Management
Initial management for uncomplicated acute low back pain and/or radiculopathy typically involves medical management and physical therapy 1.Key Recommendations
Imaging studies are not warranted for uncomplicated acute low back pain and/or radiculopathy 1. (Evidence: Expert opinion)
Consider imaging for patients with persistent low back pain and/or radiculopathy after up to 6 weeks of medical management and physical therapy without significant improvement 1. (Evidence: Expert opinion)
Consider imaging for patients presenting with red flags that raise suspicion for serious underlying conditions like cauda equina syndrome, malignancy, fracture, or infection 1. (Evidence: Expert opinion)References
1 Hutchins TA, Peckham M, Shah LM, Parsons MS, Agarwal V, Boulter DJ et al.. ACR Appropriateness Criteria® Low Back Pain: 2021 Update. Journal of the American College of Radiology : JACR 2021. link