Rheumatology Search
Rheumatology Rheumatology
low%20back%20pain
LOW BACK PAIN
It is pain, stiffness, or discomfort in the lower back area below the costal margin & above the gluteal creases.
Low back pain is also called spinal pain or lumbago.
Nonspecific low back pain is without identifiable specific causes that makes up 85-90% of all low back pain cases.  It also includes pain felt in the proximal lower extremities
Patients with low back pain maybe associated with mobility deficits caused by severe or progressive neurologic disorders or comorbidities.
Specific spinal pathology includes cauda equina syndrome, tumor, infection, ankylosing spondylitis, inflammatory disorders.
Low back pain associated w/ radiculopathy or spinal stenosis are dermatomal pain w/ or w/o neurologic deficits that most often caused by nerve root compression.

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 & 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 w/ 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 w/ leg pain, & fractures
Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS Rheumatology digital copy today!
Sign In To Download
Editor's Recommendations
Most Read Articles
Beta-blockers may reduce mortality in patients with heart failure, renal dysfunction
Roshini Claire Anthony, 6 days ago

Beta-blockers could reduce mortality risk in patients with heart failure with reduced ejection fraction (HFrEF) and moderate or moderately-severe renal dysfunction without causing harm, according to the BB-META-HF* trial presented at ESC 2019.
Reducing risks and improving long-term outcomes in patients with CHB
Prof. Vincent Wong, Prof. Ray Kim, Dr. Tan Poh Seng, 10 Sep 2019
Chronic hepatitis B (CHB) remains a major public health concern because of its worldwide distribution and potential adverse sequelae, including cirrhosis and hepatocellular carcinoma (HCC). At a recent symposium held during the GIHep Singapore 2019, Professor Vincent Wong from the Chinese University of Hong Kong and Professor Ray Kim from the Stanford University School of Medicine, Stanford, California, US, discussed antiviral treatments for CHB, with a focus on the novel agent tenofovir alafenamide (Vemlidy®). Dr Tan Poh Seng from the National University Hospital, Singapore, chaired the symposium.
Early-life exposures affect BP in children
11 Sep 2019
Blood pressure (BP) in children is influenced by early-life exposure to several chemicals, built environment and meteorological factors, suggests a study.
UTI risk not raised with SGLT-2is in real-world study
Pearl Toh, 18 hours ago
The use of SGLT-2* inhibitors was not associated with a higher risk of severe or nonsevere urinary tract infections (UTIs) in patients with type 2 diabetes (T2D) compared with DPP**-4 inhibitors or GLP-1*** receptor agonists, a population-based cohort study shows.