Back Pain: background, aetiology, diagnosis and treatment (original) (raw)
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Back Pain, Causes, Symptoms and Physiotherapy
Journal of orthopedics & bone disorders, 2019
Every fourth woman and every sixth man in the world coming to the Orthopedic or Neurology Departments complain of spinal pains-information from WHO, Decade of Bones and Joints 2000-2010 (Lars Lidgren). According to our observations there are six main causes of such spinal disorders: 1. Lumbar Hyperlordosis causes by flexion contracture of hips and in result anterior tilt of the pelvis. Common in persons with Minimal Brain Dysfunction (MBD). Pain syndromes appear after overstress in some kinds of jobs or in sport. 2. Lumbar or thoracic-lumbar left convex "C" scoliosis in 2nd/A etiopathological group (epg) or "S" scoliosis in 2nd/B epg in Lublin classification. Pain syndromes appear after overstress in some kinds of jobs or in sport. 3. Stiffness of the spine as clinical sign of "I" scoliosis in 3rd epg group in Lublin classification. 4. Spondylolisthesis or spodylolisis in sacral-lumbar or lumbar spine. 5. Urgent "nucleus prolapsed" (in German "Hexen Schuss"). 6. Extremely cooling of the back part of trunk during work or intensive walking in low temperature. In many of patients in clinical examination we see positive Laseguae test. Sometimes we see weakness of extensors of the feet or paresis of the foot. Our observations confirm that not surgery, but physiotherapy can be beneficial to the patients with spinal problems.
Acta Scientific Orthopaedics, 2019
Back pain is so common and can be traced back to the recorded history of the mankind but still a jigsaw puzzle for the doctors. No medical problem of the human body matches in mysteriousness of the Back pain, leading to so many fears, fallacies, folk stories, and mysterious remedies making it enigma for medical community. It looks so strange that it is so common as 4 out of 5 of us experience it in our lifetime but at the same time the least understood phenomenon it is. Hundreds of etiological factors were suspected in the history including even the Devil's involvement, similar numbers of remedies were advised and practiced ranging from simple assurance to heroic and novel surgery, that suggests neither we know the exact cause nor its treatment. The modern diagnostic modalities have made the situation even more confusing, making the physicians to depend more on the modern technology of imaging and less of clinical capability. A brief overview of early theories and modes of managements are discussed bringing up to the present thoughts and management. The future of its management is left open for the audience to think and explore the definite management instead of treating back pain myopically and suspecting disc and degeneration as main culprit and treating it with undue surgery. Biological management of back pain and sciatica is in experimental stages and should also be explored instead of relying on it blindly as we are practicing surgery as the best option at present.
Current concepts in low back pain: a review
Complementary Therapies in Medicine, 1993
The epidemic nature of back pain is often attributed to changing lifestyles. The size of the problem is reflected by the lack of its preventive management, despite an improved understanding of the nature of the complaint. Although defiant of attempts at uniform classification, back pain is most oRen attributed to mechanical causes and several new methods are emerging, both for the investigation and treatment of these. The future calls for more active treatment strategies, supported by agreed terminologies. This would replace the transparently futile pursuit of fundamental pathology, esoteric treatment approaches, and inappropriate referral to surgeons.
Chapter 4 European guidelines for the management of chronic nonspecific low back pain
European Spine Journal, 2006
Assistance with summaries and quality rating of exercise trials; assistance with literature management EMMA HARVEY University of Leeds Assistance cross-checking the SRs/RCTs on exercise JO JORDAN Chartered Soc Physio, UK Assistance with summaries and quality rating for KATHERINE DEANE Uni Northumbria, UK additional exercise trials 4 consisted of three women and eight men from various disciplines, representing 9 countries. None of the 11 members believed they had any conflict of interest. The WG for the chronic back pain guidelines had its first meeting in May 2001 in Amsterdam. At the second meeting in Hamburg, in November 2001, five sub-groups were formed to deal with the different topics (patient assessment; medical treatment and invasive interventions; exercise and physical treatment and manual therapy; cognitive behavioural therapy and patient education; multidisciplinary interventions).
Low back pain: a call for action
Lancet (London, England), 2018
Low back pain is the leading worldwide cause of years lost to disability and its burden is growing alongside the increasing and ageing population. Because these population shifts are more rapid in low-income and middle-income countries, where adequate resources to address the problem might not exist, the effects will probably be more extreme in these regions. Most low back pain is unrelated to specific identifiable spinal abnormalities, and our Viewpoint, the third paper in this Lancet Series, is a call for action on this global problem of low back pain.
Clinical evidence, 2004
INTRODUCTION: Over 70% of people in resource-rich countries develop low back pain (LBP) at some time. But recovery is not always favourable: 82% of non-recent-onset patients still experience pain one year later. Many chronic patients who were initially told that their natural history was good spend months or years seeking relief. METHODS AND OUTCOMES: We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of oral drug treatments? What are the effects of injection therapy? What are the effects of non-drug treatments? We searched: Medline, Embase, The Cochrane Library, and other important databases up to May 2007 (BMJ Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). RESULTS: We found 74 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. CONCLUSIONS: In this systematic review, we present information relating to the effectiveness and safety of the following interventions: acupuncture, analgesics, antidepressants, back schools, behavioural therapy, electromyographic biofeedback, exercise, injections (epidural steroid injections, facet joint injections, local injections), intensive multidisciplinary treatment programmes, lumbar supports, massage, muscle relaxants, non-steroidal anti-inflammatory drugs (NSAIDs), spinal manipulative therapy, traction, and transcutaneous electrical nerve stimulation (TENS).
Clinical evidence, 2004
INTRODUCTION: Low back pain (LBP) affects about 70% of people in resource-rich countries at some point. Acute low back pain is usually perceived as self-limiting; however, one year later, as many as 33% of people still have moderate-intensity pain and 15% have severe pain. It has a high recurrence rate; 75% of those with a first episode have a recurrence. Although acute episodes may resolve completely, they may also increase in severity and duration over time. METHODS AND OUTCOMES: We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of oral drug treatments for low back pain? What are the effects of local injections for low back pain? What are the effects of non-drug treatments for low back pain? We searched: Medline, Embase, The Cochrane Library, and other important databases up to May 2007 (Clinical Evidence reviews are updated periodically, please check our website for the most upto-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). RESULTS: We found 34 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. CONCLUSIONS: In this systematic review we present information relating to the effectiveness and safety of the following interventions: acupuncture, advice to stay active, analgesics (paracetamol, opioids), back exercises, back schools, bed rest, behavioural therapy, electromyographic biofeedback, epidural corticosteroid injections, lumbar supports, massage, multidisciplinary treatment programmes, muscle relaxants, non-steroidal antiinflammatory drugs (NSAIDs), spinal manipulation (in the short term), temperature treatments (short wave diathermy, ultrasound, ice, heat), traction, and transcutaneous electrical nerve stimulation (TENS).