• Low Back Pain

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Back pain is common

  • About 1 in 2 adults each year have back pain.
  • More than 2 in 3 adults will have at least one disabling episode of low back pain in their lives
  • One of the most common cause of physician visit.
  • One of the most common cause of missed work days.
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Common types

  • Nonspecific low back pain
  • Nerve root pain (Sciatica)

Causes

  • Coming from back:

    • Dysfunction of the intervertebral joints, minor strain to muscles and/or ligaments (Mechanical low back pain): Most common cause
    • Spondylosis (Also known osteoarthritis and degenerative back disease)
    • Lumbar disk disease
    • Facet syndrome
    • Myofascial pain syndrome
    • Osteoporosis

  • Non-Back causes

    • Depression
    • Abdominal problems: Penetrating peptic ulcer, Cholecystitis
    • Retroperitoneal problems: Renal disease including urinary tract infection, Neoplasm, Pancreatitis, Bleeding, Aortic aneurysm
    • Pelvic problems
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It is important to rule out the red flags

  • Neurological deficit
  • Fracture
  • Tumor
  • Infection

Diagnosis

Your doctor will usually ask questions about your symptoms and examine you. The most common diagnosis is nonspecific low back pain and no tests are needed. In certain situations, tests such as X-rays, MRI, Electrodiagnosis (EMG, NCS) or blood tests may be advised.

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back pain lbp 01 - کمر درد - کمردرد

Management

  • Usually no investigation needed initially
  • Stay active
  • Relative rest:
    • Resting for 2 days lying on a firm surface could be optimal treatment
    • Longer than 3 days of rest have not additional benefit
  • Heat benefits some patients specially in the first 2–4 weeks of low back pain.
  • Regular non-opioid analgesics: Paracetamol, NSAIDs
  • Exercises
    • An early graduated exercise program when the acute phase settles
    • All forms of exercise can be effective.
    • Swimming is an excellent activity

Please review Non-surgical Modalities Treatment in Musculoskeletal Pain. Some of these methodes could be applicable in back pain, you can consult with your physician.

Let’s see the video about Exercises for Back Pain Relief in Instagram.