Lower back pain also known as lumbago is a common, painful condition affecting the lower portion of the spine. It is the second topmost reason people visit the hospital. Lower back pain is responsible for the most common disabilities among people 45 years of age and under. In the United States, the annual prevalence is between 15% and 45%.
It is important to note that the exact cause of lower back pain in usually difficult to pinpoint. This is because there are many factors that could be responsible.
When the symptoms of lower back pain is alarming, cancer could be responsible, especially when the symptoms are followed by unexplained weight loss, failure to improve with treatment, pain for more than 6 weeks, and pain at night or rest.
lumbago
Alarming symptoms for infection include fever, rest pain (this is a severe pain in the legs and feet that occurs while a person is resting), recent infection (urinary tract infection, cellulitis, pneumonia), or history of immune-compromise or injection drug use. The cauda equina syndrome (which a condition that occurs when the bundle of nerves below the end of the spinal cord known as cauda equina is damaged) is suggested by urinary retention or incontinence, saddle anesthesia (which is a loss of sensation restricted to the area of the buttocks, perineum and inner surfaces of the thighs), fecal incontinence, lower body parts weakness and progressive neurologic deficits.
OTHER RISK FACTORS TO LOWER BACK PAIN INCLUDES
- Use of corticosteroids e.g.,
- Age greater than 70 years
- History of osteoporosis
- Recent significant trauma or very severe focal pain
- Abdominal aortic aneurysm
- Peptic ulcer disease
- Kidney stones
- Pancreatitis
TREATMENT
ERADICATION OF INFECTIONS AND OTHER DISEASES CAUSING LOW BACK PAIN
Diseases and infections like peptic ulcer disease, kidney stones and so on need to be diagnosed and treated, if they are implicated as the cause of low back pain.
CONSERVATIVE MANAGEMENT
Non pharmacological treatments are important in the management of lower back pain. It necessary to note that education alone improves patients’ satisfaction with recovery and recurrence. Patients’ need to be reassured when diagnostic procedures are unimportant.
Education on the following is needed to forestall recurrence; proper lifting techniques, abdominal wall/core strengthening and stabilization which effectively reduce pain and functional limitation.
Improvements in posture, core stability strengthening, physical conditioning, and modifications of activities to decrease physical strain are keys for ongoing management.
Non-steroidal anti-inflammatory drugs (NSAIDs) are effective in the early treatment of low back pain e.g. diclofenac.
Muscle relaxants are best used if there is true muscle spasm that is painful rather than simply a protective response.
Opioids may be necessary to alleviate pain immediately.
PHYSITHERAPY: This can also be helpful
SURGERY IS ANOTHER WAY TO MANAGE LOW BACK PAIN.
Treatment of more chronic neuropathic pain with gabapentin and tricyclic antidepressant may be helpful.
REFERENCES
CURRENT Medical Diagnosis and Treatment 2013 Papadakis et. al.