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\nBACKACHE
\nDefinition
\nBackache is also called back pain and dorsalgia
\nThis is pain felt at back from:
\n\uf07d\t spine (bone or joint)
\n\uf07d\t muscles
\n\uf07d\t nerves
\n\uf07d\t other structures
\nPain in the lower part of the back is called lumbago.<\/p>\n
Incidence
\nAbout 90% of human beings have backache at some time in their lives. Lumbago (low back pain) is one of the commonest complaints in outpatient department worldwide. <\/p>\n
Nature of Pain
\n\uf07d\tSharp ,dull, piercing, burning
\n\uf07d\tAcute: duration less than 4 weeks
\n\uf07d\tSubacute: duration of 4-12 weeks
\n\uf07d\tChronic : duration more than 12 weeks
\n\uf07d\tContinuous or intermittent
\n\uf07d\tLocalized or radiating
\n\uf07d\tMost acute backache are self-limiting lasting 2 to 12 weeks <\/p>\n
Causes
\n\uf07d\tNo obvious cause in 85% cases
\n\uf07d\tStrained muscles- most cases
\n\uf07d\tOsteoarthritis
\n\uf07d\tInjury, such as slipped disc, herniated disc
\n\uf07d\tOsteoporosis
\n\uf07d\tDegenerative disc disease
\n\uf07d\tAcute inflammation
\n\uf07d\tPsychologically-induced
\n\uf07d\tSpinal stenosis
\n\uf07d\tCancer
\n\uf07d\tInfection
\n\uf07d\tFracture
\n\uf07d\tRadicular pain (sciatica)
\n\uf07d\tTuberculosis of the spine
\n\uf07d\tSpinal deformity- scoliosis, kyphosis
\n\uf07d\tPoor sitting position
\n\uf07d\tWeight lifting
\n\uf07d\t Carrying\/lifting of heavy objects<\/p>\n
Predisposition
\n Backache is more common in the following situations:
\n\uf07d\tAge over 30
\n\uf07d\tPregnancy- 50% of pregnant women
\n\uf07d\tSocial stresses
\n\uf07d\tBad posture
\n\uf07d\tSmoking
\n\uf07d\tWork requiring twisting of body, lifting heavy objects, lots of bending.
\n\uf07d\tPatient with arthritis or osteoporosis
\n\uf07d\tHigh-heeled shoes <\/p>\n
Disease conditions
\n\uf07d\tSLIPPED DISC: bulging of disc from injury such as accident, fall, lifting heavy object, blow to back
\n\uf07d\tRUPTURED DISC: from trauma such as Road Traffic Accident, fall, subluxation of vertebral joint
\n\uf07d\tSPINAL STENOSIS: narrowing of spinal canal from arthritis usually in older people
\n\uf07d\tLUMBAGO: pain in lower lumbar spinal area
\n\uf07d\tSCIATICA: pain in the path of sciatic nerve- hips, buttocks, thighs, calf, foot
\n\uf07d\tRHEUMATISM: nonspecific term for diseases of and around joints giving pain and stiffness e.g. rheumatic fever, rheumatoid arthritis, ankylosing spondylitis, osteoarthritis, gout
\n\uf07d\tSPONDYLITIS: inflammation of 1 or more vertebrae and the attached discs and ligaments
\n\uf07d\tSPONDYLOSIS DEFORMANS: (osteoarthritis of spine) degeneration of intervertebral disc
\n\uf07d\tANKYLOSIS: fixation of a joint
\n\uf07d\tANKYLOSING SPONDYLITIS: spondylitis with ossification and fixation of spinal ligaments, especially sacroiliac joint, especially in young men
\n\uf07d\tOSTEOARTHRITIS (osteoarthrosis, degenerative disease of joints): wearing off of articular cartilage with formation of osteophytes
\n\uf07d\tSPONDYLOLISTHESIS: forward displacement of vertebra
\n\uf07d\tCAUDA EQUINA SYNDROME: disorder involving urine bladder dysfunction, lower limb weakness, gait disturbance, saddle (buttock) anaesthesia
\n\uf07d\tFIBROMYALGIA: pain and tenderness in muscles and ligaments of back
\n\uf07d\tOSTEOPOROSIS: loss of bone density <\/p>\n
Investigations
\nInvestigations to ascertain the cause of backache include:
\n\uf0a7\tBlood tests, e.g. full blood count, ESR
\n\uf0a7\tDiagnostic imaging tests, such as X-ray, MRI
\n\uf0a7\tUrinalysis<\/p>\n
Management of Backache
\nThere is spontaneous recovery of acute backache within one month in about 75% of the cases.
\nFor backache treatment options are:
\n\uf07d\tMassage
\n\uf07d\tCorsets and braces
\n\uf07d\tDrugs
\n\uf07d\tSurgery
\n\uf07d\tLocal medications
\n\uf07d\tPhysiotherapy
\n\uf07d\tAcupuncture, etc.?
\n\uf07d\tPsychotherapy <\/p>\n
Drugs
\nThese include:
\n\uf07d\tMuscle relaxants
\n\uf07d\tNon-steroidal anti-inflammatory drugs (NSAIDS)
\n\uf07d\t Opioids
\n\uf07d\tParacetamol<\/p>\n
Surgery
\nThere may be need for surgery in 1-10% of people with backache. Possible surgeries are for:
\n\uf07d\tLumbar disc herniation
\n\uf07d\tCompression fracture
\n\uf07d\tScoliosis
\n\uf07d\tSpinal stenosis<\/p>\n","protected":false},"excerpt":{"rendered":"
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