Correlation between the Clinical and Radiological Findings of Chronic Low Back Pain with Radiculopathy in Adult Indian Patients: A Prospective Observational Single-center Study
Kaushal Malhan, Timothy RodricksBackground:
Low back pain is a universal problem in adult population, often managed symptomatically. When it persists, and is yoked with radiculopathy, further investigative measures must be considered in order to determine its origin.
Objective:
The objective of this study was to evaluate how clinical symptoms align with radiologic findings in Indian patients with low back pain (LBP), thereby clarifying patterns of underlying causes and supporting clinicians in determining the need for imaging and guiding appropriate medical or surgical management.
Material and Methods:
A prospective, single-center, observational study conducted at Fortis Hospital, Mumbai, wherein adult patients visiting the outpatient department, intensive care units and Wards of the hospital with LBP were included, after applying screening criteria. Clinical assessments (straight leg raise, Schober’s, FABER), X-rays and 3T magnetic resonance imaging (MRI) scans were performed. MRI showed disc degeneration, herniation, annular tears, HIZ and Modic changes, which were graded using the Christian and Boos classification (2004).
Results:
The study included 120 patients (mean age 60.4 years), mostly male, with over half reporting pain lasting ≤6 months and predominantly bilateral radiation to the ankle. Clinical assessment showed disc degeneration and herniation as primary findings, with L4–L5 most affected. MRI commonly revealed diffuse disc bulge and stenosis, while most patients had moderate visual analogue scale (VAS) pain scores. A strong, statistically significant correlation (
Conclusion:
Most patients reported long-standing bilateral radiating pain with moderate VAS scores. Clinical assessment indicated disc degeneration, herniation, nerve root compression and stenosis, while MRI detailed disc bulges, arthropathy, canal and recess narrowing, and listhesis, mainly at L4–L5. Pain severity strongly correlated with MRI grading, confirming symptom–imaging concordance.