4. Why back pain is important
Common case
Quality of life
Quality of work carried out when suffering pain
5. Causes of low back pain
Simple back pain :( not clear cause )
95% of cases , Over 90 % of patients will get better within 6 weeks
Spondylitis:
Pain is worse at rest but improves with physical activity.
Sciatica:
pain radiates to the leg
Others: (Malignancy , osteomyelitis , pyelonephritis , etc )
7. Diagnosis
Specific questions to ask the patient
age
Pain that radiates into the
buttocks implies nerve root
compression ( Sciatica )
patient must be referred
location
children under 15 : refer all
( spondylolysis , malignancy )
Older than 50 : refer all
(osteoporosis and malignancy )
8. Diagnosis
Onset Restriction of movement
Specific questions to ask the patient
pain lasts longer than 6 weeks
patient must be referred
acute low back pain in the
elderly should be referred
Mechanical causes of pain is
relieved by rest
Systemic causes of back pain
are usually worse with rest
Weakness or numbness
Progressive muscle weakness must be referred
9. Treatment
Analgesics {paracetamol, aspirin, NSAIDs}
paracetamol may be the best first-line choice for most people
Studies found that NSAIDs were no better than paracetamol for LBP
Compenation analgesics {paracetamol/codeine }
OTC doses of codeine are too low to produce significant
reductions in pain compared to single agents
10. Treatment
Antihistamines (doxylamine) and Caffeine
They are available in combination with paracetamol to
enhance the analgesic efficacy
Topical NSAIDs
Topical NSAIDs can provide good pain relief in acute musculoskeletal
conditions, without the adverse events seen with oral NSAIDs
