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Back pain

Back pain is the second reason responsible for absenteeism from work after the common flux.

Back pain is one of humanity's most frequent complaints.

Back pain is pain felt in the back that usually originates from the muscles, nerves, bones, joints or other structures in the spine.

Epidemiology

Back pain affects 80% of adults at some point of their life and occurs at all ages.

Classification

Back pain may have a sudden onset or can be a chronic pain; it can be constant or intermittent, stay in one place or radiate to other areas. It may be a dull ache, or a sharp or piercing or burning sensation. The pain may radiate into the arms and hands as well as the legs or feet, and may include symptoms other than pain. These symptoms may include tingling, weakness or numbness.

see Axial back pain.

see Chronic back pain.

see Low back pain

Diagnosis

Initial assessment consists of a history and physical examination focused on identifying serious underlying conditions such as fracture, tumor, infection or cauda equina syndrome. Serious conditions presenting as low back problems are relatively rare.

The value of early diagnostic imaging in older adults for back pain without radiculopathy is uncertain 1).

The following information has been found to be helpful in identifying patients with serious underlying conditions such as cancer and spinal infection.

1. age

2. history of cancer (especially malignancies that are prone to skeletal metastases: prostate, breast, kidney, thyroid, lung, lymphoma/myeloma)

3. unexplained weight loss

4. immunosuppression: from steroids, organ transplant medication, or HIV

5. prolonged use of steroids

6. duration of symptoms

7. responsiveness to previous therapy

8. pain that is worse at rest

9. history of skin infection: especially furuncle

10. history of IV drug abuse

11. UTI or other infection

12. pain radiating below the knee

Differential diagnosis

Back pain differential diagnosis.

Treatment

see Back pain treatment.

Links

arc BackCare - The Charity for Healthier Backs BOA ISSLS National Centre for Osteopathic Research (NCOR) Scottish Society of Rehabilitation Spinal News International - The newspaper for the spinal specialist Spine Health The Bone & Joint Journal The Bone & Joint Journal - Orthopaedic Proceedings The United Kingdom Spine Societies Board (UKSSB) represents the Society for Back Pain Research (SBPR), the British Scoliosis Society (BSS) and the British Association of Spine Surgeons (BASS

1)
Jarvik JG, Gold LS, Comstock BA, Heagerty PJ, Rundell SD, Turner JA, Avins AL, Bauer Z, Bresnahan BW, Friedly JL, James K, Kessler L, Nedeljkovic SS, Nerenz DR, Shi X, Sullivan SD, Chan L, Schwalb JM, Deyo RA. Association of early imaging for back pain with clinical outcomes in older adults. JAMA. 2015 Mar 17;313(11):1143-53. doi: 10.1001/jama.2015.1871. Erratum in: JAMA. 2015 May 5;313(17):1758. PubMed PMID: 25781443.
back_pain.txt · Last modified: 2020/03/03 16:43 by administrador