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Back Pain Solutions Without Surgery
by Hemant Yagnick, M.D., Walton Pain Center
Acute back pain may begin suddenly and usually lasts around three months.
Chronic back pain sometimes lasts throughout life.
The most common back pain is low back pain (LBP). It is is often described as
sudden, sharp, persistent, or dull pain felt below the waist. LBP is very common
and affects the majority of people at some point during their life. Up to 70 –
85 percent of all people have back pain at some time in their lives.
LBP is the most common cause of a limitation of activity in people younger than
45 years of age. It is the second most frequent reason for visits to a physician,
and the third most common indication for surgery. It is the fifth-ranking cause
of hospital admissions and is one of the leading causes of disability.
Low back pain is most commonly caused by muscle strain associated with heavy
physical work, lifting or forceful movement, bending or twisting, awkward
positions, or standing in one position too long. Any of these movements can
exacerbate a prior or existing back disorder.
Other conditions that can cause low back pain include spinal stenosis, arthritis
(osteoarthritis), spinal infection (osteomyelitis), spinal tumors (benign and
malignant), spondylolisthesis, and vertebral fractures (e.g. burst fracture).
Low back pain is either acute or chronic. Acute LBP may begin suddenly with
intense pain usually lasting fewer than three months. Chronic pain is persistent
long-term pain, sometimes lasting throughout life. Even chronic pain may present
episodes of acute pain.
Other symptoms include localized pain in a specific area of the low back,
general aching, and/or pain that radiates into the low back, general aching,
and/or pain that radiates into the low back, buttocks and leg(s). Sometimes pain
is accompanied by neurological symptoms such as numbness, tingling, or weakness.
Neurological symptoms requiring immediate medical attention include bowel or
bladder dysfunction, groin or leg weakness or numbness, severe symptoms that do
not subside after a few days, or pain prohibiting everyday activities.
Pain felt in the low back is not always indicative of a spinal problem. A
thorough physical and neurological assessment may reveal the cause of the low
back pain. The physical examination begins with the patient's current condition
and medical history. Examination of a patient with low back pain involves
examining the patient's range of spinal motion while standing straight, bending
forward, and to the side.
Asymmetry, posture, and leg length is noted. Methodical palpation of the spine
can reveal muscle spasm, possible bony displacement, and tender points.
Abdominal palpation is performed to determine if the cause of low back pain is
possibly organ related (e.g. pancreas).
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