Back Pain

Back Pain

1. Anatomy

   • Vertebral column
     • vertebra
       • coccyx
         • sacrum
           • lumbar
             • thoracic
               • cervical
     • curvatures
       • sacral kyphosis
         • lumbar lordosis
           • thoracic kyphosis
             • cervical lordosis
       • abnormal curvatures
         • scoliosis
         • kyphosis
         • lordosis
     • Joints
       • atlantoaxial
         • atlantooccipital
           • facet joint
             • Intervertebral joint
     • ligaments
     • muscles
     • spinal cord

2. Possible Causes

   • Congenital
   • Neoplastic
     • Spinal Osteosarcoma
       • malignant bone tumors
   • Metabolic
     • osteoporosis
       • weakening of preconstructed bone
     • osteomalacia
       • softening of bones
   • Referred
     • pelvic inflammatory disease
     • kidney stones
   • Degenerative
     • Degenerative disc diease
   • Mechanical
     • Back Muscle Strain
       • torn back muscle
     • Spondylolisthesis
       • anterior deviation of a vertebra compared to other vertebra
     • Herniated Disc
       • bulging of nucleus polposus cause of the damage of annulus fibrosis

3. Sciatica

   • pain that radiates along the path of the sciatic nerve
     • Sciatic nerve
       • largest nerve in the body
       • originates from lumbosacral nerves
         • L4,L5,S1,S2,S3
       • innervates the posterior aspect of the thigh and gluteal region and lower leg
     • due to compressions of the roots of the nerve
       • can be caused by a lot of conditions
   • History Taking
     • Duration
       • Location
         • Progression
           • Radiation
             • Quality
               • Quantity
                 • Alleviating and Aggravating factors
                   • Associated Symptoms
     • VAS-Visual Analogue Scale
       • measures intensity of pain
     • Physical Examination
       • Look
         • deformity
           • muscle wasting
             • swellings
       • Feel
         • tenderness
           • spasm
       • Move
         • cervical movements
           • thoracolumbar movements
   • Management
     • nonsurgical treatment
       • heat/ice
       • pain medications
       • epidural steroid injections
       • physiotherapy
         • press ups
         • lumbar stabilisation
     • surgical treatment
       • microdiscectomy
       • lumbar laminectomy
     • alternative therapy
       • acupuncture
         • stimulates release of endorphins to reduce pain
       • chiropractic
         • spinal manipulation and manual manipulation
         • mobilization
       • cognitive behaviour therapy
         • taking control and changing self-defeating behaviours
       • massage therapy
         • used to increase endorphin release and relax the muscles and increase range of motion

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