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by Thomas Lemon, Cardiff
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
Acute – less than 4 weeks
Sub acute – 4-12 weeks
Chronic – greater than 3 months
- Neck pain
- Upper back pain
- Lower back pain
Leading cause of disability in American under
Bigger picture – things to
Economical aspects – disability of workforce
Quality of work carried out when suffering
Carrying a heavy backpack
Stress and muscle tension
Sudden physical exertion
Lack of muscle tone
Arthritis ( Chronic)
Numbness or difficulty moving extremities
Impaired bladder control
Fever or severe headache
60+ and history of long term steroid use
MI or angina symptoms
No improvement within 72 hours
Hot and cold compresses
NSAIDS, aspirin, ibuprofen, acetaminophen
or naproxen sodium
Bed rest IS NOT best
Slow movement is important to good recovery
A Healthy Lifestyle
Nutrient rich diet
Avoid smoking and excessive alcohol
Maintain a healthy BMI
Drink lots of water
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
A- Spinal stenosis
C- Prolapsed interverbebral disc
Answer - Prolapsed intervertebral disc
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
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