Low back Pain. By. Dr. M H Jaffer. Lower back structures. Spinal cord Muscle Ligaments Uterus Ovaries Kidneys Pelvis. Common causes. Osteoporosis Muscle cramps UTI Cancer Periods Weight gain Pregnancy. Trauma PID PID Arthritis Congenital Depression Infection (shingles)
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Low back Pain By. Dr. M H Jaffer
Lower back structures • Spinal cord • Muscle • Ligaments • Uterus • Ovaries • Kidneys • Pelvis
Common causes • Osteoporosis • Muscle cramps • UTI • Cancer • Periods • Weight gain • Pregnancy
Trauma • PID • PID • Arthritis • Congenital • Depression • Infection (shingles) • Mineral deficiency • Pyelonephritis • Renal stones
All pain needs to be SOCRATISED • Site • Onset • Character • Radiation • Associated factors • Time • Events • Severity
How it helps • A pain that is worse in the morning, Better as the day passes, sometimes worse at night Associated with stiffening Other joints may be affected as well Swelling anywhere in the body Chronic (more than 6 weeks…some say 3 months)
How it helps… • A pain that is chronic but is always there not better when ADL are performed worsening over time since started associated with any other symptoms… even cough, menorrhagia or LUTS…. May be debilitating
How it helps… • A pain that is worse in the evening times Not so bad at other times of the day Gets better and worse for a long time Of gradual onset and a sensation of buildup over time Worse when resting (more felt!)
How it helps… • A pain that is of sudden onset Sharp and debilitating Worse in a particular position/when moving, better when stationary Radiates to the limbs Centrally located
Remember • Patients don’t read books! • Watch out for sympathy seekers • Probe into other symptoms always • Nutrition and old age is a major issue • Exercise is not for every backpain • Take a thorough history and socratise!!!
Back mechanics… • Don’t twist, bend and pick…. • Don’t put weight on back when lifting heavy object, bend knees! • Sit up straight • Stretch often!!
What we can do about it • Depending on cause • Massage, antipain meds, • Supplements • Anti infective agents • Relax the back • Posture • Physiotherapy • Treatment of chronic cause
Beds-cotton better than sponge • Aids for muscle strength (support) • Wt loss • Acupuncture • Cyropractor • Social problems + stress reduction • Surgery (laminectomy, others)
Lessons • Don’t ignore • Don’t encourage • Council on side effects • Don’t tolerate • Lifestyle modifications are necessary • “If it ain’t broke don’t fix it!!!”
Thank you for listening Have a great day!!!