CBC/ESR if febrile or an abscess/osteomyelitis is suspected; HbA1c for suspected diabetic neuropathy; coagulation profile/INR before any injection or procedure, or if on blood thinners. Add a new row each time a test is repeated so values can be tracked over successive visits.

Consider when the picture suggests inflammatory arthropathy, CRPS, or an autoimmune process (e.g., rheumatoid arthritis, lupus, axial spondyloarthropathy) rather than purely mechanical pain.

Standard practice at initiation of chronic opioid therapy and periodically thereafter, per ASIPP/APS/AAPM guidance — frequency should scale with the patient's assessed risk. Each check gets its own dated row.

Uncomplicated acute back/joint pain rarely needs imaging up front. X‑ray first if trauma, osteoporosis, or chronic steroid use; MRI is the study of choice for red flags or symptoms persisting past ~6 weeks of conservative care; EMG/NCS helps localize radiculopathy, neuropathy, or CRPS type II. Repeat scans get their own dated row so the series reads chronologically.

Terminology follows the Fardon/Milette combined task force lumbar spine nomenclature (NASS / American Society of Spine Radiology / American Society of Neuroradiology, version 2.0) — bulge, protrusion, extrusion, and sequestration are distinguished by shape and containment, not by severity; a bulge is not a form of herniation. This reflects the most recent MRI; use the dated imaging log above to track findings across multiple scans.