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LOW BACK PAIN

It is pain, stiffness, or discomfort in the lower back area below the costal margin and above the gluteal creases.
Low back pain is also called spinal pain or lumbago.
Nonspecific low back pain is without identifiable specific causes and makes up 90-95% of all low back pain cases. It also includes pain felt in the proximal lower extremities.
Patients with low back pain may have mobility deficits caused by severe or progressive neurologic disorders or comorbidities.
Specific spinal pathology includes cauda equina syndrome, tumor, infection, ankylosing spondylitis, or inflammatory disorders.
Low back pain associated with radiculopathy or spinal stenosis is dermatomal pain with or without neurologic deficits that is most often caused by nerve root compression.

Low%20back%20pain Management

Management

Prevention

Strengthening exercises for the spinal area are recommended
Smoking contributes to development of back diseases; joining smoking cessation programs may help patients decrease or quit cigarette addiction

Weight Loss Programs

Exercise and weight loss programs may help reduce additional weight pressure on already fragile spinal bones

Follow Up

Follow-ups should be more frequent at the start of therapy, then gradually reduced when treatment goals have been established
Encourage compliance especially with exercise regimens
Watch out for yellow flags
Evaluate new symptoms thoroughly, especially for presence of red flags

Specialist Referral

Patient should be referred to a specialist if control is not achieved despite adequate treatment
May refer to Rehabilitation specialist for continuation/maintenance of rehabilitation
Consider referral to a surgeon for the following:
- Preservation of neurological function
- Presence of tumors, spinal stenosis, disc prolapse associated with leg pain, and fractures