Low back pain question well explained 2023/2024.

Etiology & pathophysiology of lower back pain - answersAcute lower back pain Chronic lower back pain Treatment: Collaborative Care Herniated Intervertebral Disk Etiology & pathophysiology Collaborative Care/Surgery Etiology and Pathophysiology - answersAffects most adults at least once 45% of sufferers seek medical attention Low back pain is common and has probably affected 70% to 85% of adults at least once during their lifetime In persons younger than age 45, low back pain is responsible for many lost working hours Low back pain common because lumbar region - answersBears most of the weight of body Is the most flexible region of the spinal column Contains nerve roots that are vulnerable to injury or disease Has an inherently poor biomechanical structure Several risk factors - answersLack of muscle tone Excess body weight Poor posture Cigarette smoking Stress Associated with low back pain - answersProlonged periods of seating Repetitive heavy lifting Vibration Low back pain most often due to musculoskeletal problems - answersAcute lumbosacral strain Instability of lumbosacral bony mechanism Osteoarthritis of lumbosacral vertebrae Degenerative disk disease Herniation of intervertebral disk Lasts 6 weeks or less - answersAssociated with some type of activity that causes undue stress on tissues of lower back Symptoms often do not appear at time of injury but develop later because of gradual ↑ in paravertebral muscle spasms Few definitive diagnostic abnormalities with paravertebral muscle strain - answersOne test is straight-leg raise. Positive for disk herniation when radicular pain occurs MRI and CT not done unless trauma or systemic disease is suspected Lasts longer than 3 months or is a repeated incapacitating episode - answersCauses Degenerative disk disease Lack of physical exercise Prior injury Obesity Structural and postural abnormalities Systemic disease Osteoarthritis (OA) - answersof lumbar spine is found in patients over 50. Chronic back pain in younger patients with OA usually involves thoracic or lumbar spine. Discomfort is ↑ following periods of inactivity. Particularly on awakening or after long periods of sitting Treatment regimens for chronic back pain - answersReduction in pain associated with daily activities Formal back pain program Ongoing medical care Rest and local heat application when cold, damp weather aggravates back pain Treatment regimens (Cont.) - answersMild analgesics to decrease pain and stiffness Integral to daily comfort Weight reduction Sufficient rest periods Local heat and cold application Exercise and activity throughout day Keep muscle and joints mobilized Tricyclic antidepressants & Serotonin reuptake inhibitors Both have been shown to improve chronic symptoms. Surgical interventions may be indicated for patients - answersWith severe chronic low back pain Who do not respond to conservative care Who have neurological deficits Treated on an outpatient basis if acute muscle spasms and pain are not severe and debilitating - answersAnalgesics Muscle relaxants Massage and back manipulation Alternating use of heat and cold compresses Opioid analgesics for severe pain