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Acute back
pain
by Thomas Lemon, Cardiff
University
Aims
 Classification of acute back pain
 Importance of acute back pain
 Identify common aetiology of acute back pain
 ...
Classification
 Acute – less than 4 weeks
 Sub acute – 4-12 weeks
 Chronic – greater than 3 months
ALSO anatomically
- ...
 Leading cause of disability in American under
45s
Bigger picture – things to
consider…
 Economical aspects – disability of workforce
 Sick days
 Quality of work carried ...
Common causes
 Sleeping position
 Poor posture
 Carrying a heavy backpack
 Stress and muscle tension
 Incorrect lifti...
Backpacks
Also
 Lack of muscle tone
 Excess weight
 Pregnancy
 Arthritis ( Chronic)
RED FLAGS
 Numbness or difficulty moving extremities
 Impaired bladder control
 Fever or severe headache
 60+ and hist...
Treatment
 Home remedies
 Hot and cold compresses
 NSAIDS, aspirin, ibuprofen, acetaminophen
or naproxen sodium
 Bed r...
Preventing re-injury
Exercise
 Cardiovascular
 Stretching
 Core strengthening
A Healthy Lifestyle
 Nutrient rich diet
 Avoid smoking and excessive alcohol
 Maintain a healthy BMI
 Drink lots of wa...
Quiz
 A 39 year old care worker presents with acute
back pain and right sided buttock pain
following lifting a patient. O...
Quiz
Answer - Prolapsed intervertebral disc
Why?
Neuro signs after examination are present sometimes -
otherwise only loca...
Key References
 Borenstein DG, O'Mara JW, Boden SD, et al. (2001). "The value of magnetic resonance imaging of the lumbar...
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Acute back pain Presentation

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Acute back pain Presentation

  1. 1. Acute back pain by Thomas Lemon, Cardiff University
  2. 2. Aims  Classification of acute back pain  Importance of acute back pain  Identify common aetiology of acute back pain  Identify RED FLAG symptoms  Identify treatment possibilities  Ways to avoid re- injury
  3. 3. Classification  Acute – less than 4 weeks  Sub acute – 4-12 weeks  Chronic – greater than 3 months ALSO anatomically - Neck pain - Upper back pain - Lower back pain
  4. 4.  Leading cause of disability in American under 45s
  5. 5. Bigger picture – things to consider…  Economical aspects – disability of workforce  Sick days  Quality of work carried out when suffering pain
  6. 6. Common causes  Sleeping position  Poor posture  Carrying a heavy backpack  Stress and muscle tension  Incorrect lifting  Sudden physical exertion  Accidental
  7. 7. Backpacks
  8. 8. Also  Lack of muscle tone  Excess weight  Pregnancy  Arthritis ( Chronic)
  9. 9. RED FLAGS  Numbness or difficulty moving extremities  Impaired bladder control  Fever or severe headache  60+ and history of long term steroid use  MI or angina symptoms  Pregnancy  No improvement within 72 hours
  10. 10. Treatment  Home remedies  Hot and cold compresses  NSAIDS, aspirin, ibuprofen, acetaminophen or naproxen sodium  Bed rest IS NOT best  Slow movement is important to good recovery
  11. 11. Preventing re-injury Exercise  Cardiovascular  Stretching  Core strengthening
  12. 12. A Healthy Lifestyle  Nutrient rich diet  Avoid smoking and excessive alcohol  Maintain a healthy BMI  Drink lots of water
  13. 13. Quiz  A 39 year old care worker presents with acute back pain and right sided buttock pain following lifting a patient. O/E he has reduced R leg raising. Neurological examination normal.  A- Spinal stenosis  B-Ankylosing spondylitis  C- Prolapsed interverbebral disc
  14. 14. Quiz Answer - Prolapsed intervertebral disc Why? Neuro signs after examination are present sometimes - otherwise only localised pain due to neural root irritation leading to pain in affected dermatome. Pain would usually be L4/5 or L5/S1 as most common sites of injury. Posterior herniation = Cauda Equina compression
  15. 15. Key References  Borenstein DG, O'Mara JW, Boden SD, et al. (2001). "The value of magnetic resonance imaging of the lumbar spine to predict low-back pain in asymptomatic subjects: a seven-year follow-up study". J Bone Joint Surg Am 83-A (9): 1306–11.  Burke,G.L.,MD, (1964). Backache: From Occiput to Coccyx. Vancouver, BC: Macdonald Publishing. "Back Pain Exercises Routine Benefits". Retrieved June 18, 2012  ^ Hayden J, van Tulder M, Malmivaara A, Koes B (2005). "Exercise therapy for treatment of non-specific low back pain.". Cochrane Database Syst Rev (3): CD000335.DOI:10.1002/14651858.CD000335.pub2. PMID 16034851.  Jensen MC, Brant-Zawadzki MN, Obuchowski N, Modic MT, Malkasian D, Ross JS (1994). "Magnetic resonance imaging of the lumbar spine in people without back pain". N Engl J Med 331(2): 69–73  Patel, A.. "Diagnosis and Management of Acute Low Back Pain". American Academy of Family Physicians. Retrieved July 12, 2012  Roelofs PDDM, Deyo RA, Koes BW, Scholten RJPM, van Tulder MW (2008). "Non-steroidal anti-inflammatory drugs for low back pain.". Cochrane Database Syst Rev  Savage RA, Whitehouse GH, Roberts N (1997). "The relationship between the magnetic resonance imaging appearance of the lumbar spine and low back pain, age and occupation in males". Eur Spine J 6 (2): 106–14.  White AA, Gordon SL (1982). "Synopsis: workshop on idiopathic low-back pain". Spine 7 (2): 141–9. Author does not own rights to any images in the presentation.

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