For many clinical situations a therapeutic trial (conservative management) is indicated before diagnostic imaging is approrpiate. In some cases this is a matter of cost efficiency, in others it may relate to the prevalence of false positive imaging results, which may lead to unnecessary further interventions when a simple course of medication and behavioral changes would have sufficed.
1. Nonsteroidal anti-inflammatory drugs for at least three weeks (Requirement is waived if NSAIDS are not tolerated or contraindicated, or if condition worsens while under treatment.)
2. Activity modification or physical therapy if appropriate
Abnormal CBC, Sed Rate, etc.
Bladder and Bowel dysfunction
Fever
Cancer, History of Immunocompromised state
IV drug use
Major weakness of a limb
Pain increased at rest
Saddle anesthesia
Severe pain, not repsonding to opiates after two days
Trauma
Unexplained weight loss
Urinary tract infections