Back Pain

Back Pain

Anatomy
1. Vertebral column
  1. vertebra
    1. coccyx
      1. sacrum
        lumbar
        thoracic
        cervical
  2. curvatures
    1. sacral kyphosis
      1. lumbar lordosis
        thoracic kyphosis
        cervical lordosis
    2. abnormal curvatures
      1. scoliosis
      2. kyphosis
      3. lordosis
  3. Joints
    1. atlantoaxial
      1. atlantooccipital
        facet joint
        Intervertebral joint
  4. ligaments
  5. muscles
  6. spinal cord
Possible Causes
1. Congenital
2. Neoplastic
  1. Spinal Osteosarcoma
    1. malignant bone tumors
3. Metabolic
  1. osteoporosis
    1. weakening of preconstructed bone
  2. osteomalacia
    1. softening of bones
4. Referred
  1. pelvic inflammatory disease
  2. kidney stones
5. Degenerative
  1. Degenerative disc diease
6. Mechanical
  1. Back Muscle Strain
    1. torn back muscle
  2. Spondylolisthesis
    1. anterior deviation of a vertebra compared to other vertebra
  3. Herniated Disc
    1. bulging of nucleus polposus cause of the damage of annulus fibrosis
Sciatica
1. pain that radiates along the path of the sciatic nerve
  1. Sciatic nerve
    1. largest nerve in the body
    2. originates from lumbosacral nerves
      1. L4,L5,S1,S2,S3
    3. innervates the posterior aspect of the thigh and gluteal region and lower leg
  2. due to compressions of the roots of the nerve
    1. can be caused by a lot of conditions
2. History Taking
  1. Duration
    1. Location
      1. Progression
        Radiation
        Quality
        Quantity
        Alleviating and Aggravating factors
        Associated Symptoms
  2. VAS-Visual Analogue Scale
    1. measures intensity of pain
  3. Physical Examination
    1. Look
      1. deformity
        muscle wasting
        swellings
    2. Feel
      1. tenderness
        spasm
    3. Move
      1. cervical movements
        thoracolumbar movements
3. Management
  1. nonsurgical treatment
    1. heat/ice
    2. pain medications
    3. epidural steroid injections
    4. physiotherapy
      1. press ups
      2. lumbar stabilisation
  2. surgical treatment
    1. microdiscectomy
    2. lumbar laminectomy
  3. alternative therapy
    1. acupuncture
      1. stimulates release of endorphins to reduce pain
    2. chiropractic
      1. spinal manipulation and manual manipulation
      2. mobilization
    3. cognitive behaviour therapy
      1. taking control and changing self-defeating behaviours
    4. massage therapy
      1. used to increase endorphin release and relax the muscles and increase range of motion

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	Creado por Salma Mk hace casi 9 años