Low Back Pain

"By far the most common site of back pain and injury is the lumbar region-the low back. Your lumbar spine bears the brunt of bending, stooping, sitting and worst of all, lifting. Low back pain usually emanates from degenerative changes to the lumbar discs.

With aging, the resilient disc material dries out, shrinks and loses some of its "spring". Under the stress of lifting, coughing or sitting improperly, the deteriorated disc can bulge or even rupture, spilling its spongy pulp into the surrounding space.
This herniated disc can press on the adjacent nerve root. This irritation can cause pain, numbness and tingling, or painful muscle spasms.

Loss of disc thickness can also cause wear and arthritic enlargement of the facet joint, constricting the space between the vertebrae leading to abnormal pressure on the nerve."
Source

Mechanism of Injury

pend

Diagnosis

pend

Treatment

The Spine Journal Jan-Feb 2008
Note: Right click & save to access as PDF

A supermarket approach to the evidence-informed management of chronic low back pain Full Text + Links PDF (128 K)
A systematic review of low back pain cost of illness studies in the United States and internationally Full Text + Links PDF (231 K)

Evidence-informed management of chronic low back pain - Intervention review articles
Adjunctive analgesics Full Text + Links PDF (151 K)
Back schools, brief education, and fear-avoidance training Full Text + Links PDF (254 K)
Cognitive behavioral therapy Full Text + Links PDF (113 K) Epidural steroid injections Full Text + Links PDF (214 K)
Facet injections and radiofrequency neurotomy Full Text + Links PDF (679 K)
Functional restoration Full Text + Links PDF (116 K)
Herbal, vitamin, mineral, and homeopathic supplements Full Text + Links PDF (228 K)
Intradiscal electrothermal therapy Full Text + Links PDF (994 K)
Lumbar extensor strengthening exercises Full Text + Links PDF (873 K)
Lumbar stabilization exercises Full Text + Links PDF (140 K)
Massage Full Text + Links PDF (238 K)
McKenzie method Full Text + Links PDF (255 K)
Medicine-assisted manipulation Full Text + Links PDF (165 K)
Minimally invasive nuclear decompression Full Text + Links PDF (385 K)
Needle acupuncture Full Text + Links PDF (224 K)
Nonsteroidal anti-inflammatory drugs, muscle relaxants, and simple analgesics Full Text + Links PDF (217 K)
Opioid analgesics Full Text + Links PDF (207 K)
Physical activity, smoking cessation, and weight loss Full Text + Links PDF (322 K)
Prolotherapy Full Text + Links PDF (187 K)
Spinal manipulation and mobilization Full Text + Links PDF (239 K)
Transcutaneous electrical nerve stimulation, interferential current, electrical muscle stimulation, ultrasound, and thermotherapy Full Text + Links PDF (201 K)
Traction therapy Full Text + Links PDF (166 K)
Trigger point injections Full Text + Links PDF (199 K)
Evidence-informed management of chronic low back pain with watchful waiting PDF (109 K)
Low back pain with surgery Full Text + Links PDF (159 K)

What have we learned about the evidence-informed management of chronic low back pain Full Text + Links PDF (179 K)

Cochrane Reviews - Low Back Pain
Lumbar spine (38)
Rehabilitation after lumbar disc surgery HTML
Surgical interventions for lumbar disc prolapse HTML
Advice to stay active as a single treatment for low‑back pain and sciatica HTML
Bed rest for acute low‑back pain and sciatica HTML
Local anesthetic at the iliac crest donor‑site for postoperative pain management in spine surgery patients HTML
Traction for low‑back pain with or without sciatica HTML
Surgery for degenerative lumbar spondylosis HTML
Acupuncture and dry‑needling for low back pain HTML
Advice to stay active as a single treatment for low‑back pain and sciatica HTML
Antidepressants for non‑specific low‑back pain HTML
Back schools for non‑specific low‑back pain HTML
Bed rest for acute low‑back pain and sciatica HTML
Behavioural treatment for chronic low‑back pain HTML
Chiropractic interventions for low‑back pain HTML
Exercises for prevention of recurrences of low‑back pain HTML
Exercise therapy for treatment of non‑specific low back pain HTML
Herbal medicine for low back pain HTML
Injection therapy for subacute and chronic benign low‑back pain HTML
Insoles for prevention and treatment of back pain HTML
Low level laser therapy for nonspecific low‑back pain HTML
Lumbar supports for prevention and treatment of low‑back pain HTML
Manual material handling advice and assistive devices for preventing and treating back pain in workers HTML
Massage for low‑back pain HTML
Multidisciplinary bio‑psycho‑social rehabilitation for chronic low‑back pain HTML
Multidisciplinary biopsychosocial rehabilitation for subacute low‑back pain among working age adults HTML
Muscle relaxants for non‑specific low‑back pain HTML
Neuroreflexotherapy for non‑specific low‑back pain HTML
Non‑steroidal anti‑inflammatory drugs for low‑back pain HTML
Opioids for chronic low‑back pain HTML
Patient education for low‑back pain HTML
Prolotherapy injections for chronic low‑back pain HTML
Radiofrequency denervation for neck and back pain HTML
Spinal manipulative therapy for low‑back pain HTML
Superficial heat or cold for low back pain HTML
Traction for low‑back pain with or without sciatica HTML
Transcutaneous electrical nerve stimulation (TENS) for chronic low‑back pain HTML
Work conditioning, work hardening and functional restoration for workers with back and neck pain HTML
Worksite intervention for neck and back disorders in workers HTML
Interventions for preventing and treating pelvic and back pain in pregnancy Record

Guidelines

ACOEM’s Occupational Medicine Practice Guidelines: Evaluation and Management of Common Health Problems and Functional Recovery in Workers, 2nd Ed. - Low Back Disorders.
Phys Ther. 2001 Oct;81(10):1641-74.Philadelphia Panel evidence-based clinical practice guidelines on selected rehabilitation interventions for low back pain.
Ann Intern Med. 2007 Oct 2;147(7):492-504.Nonpharmacologic therapies for acute and chronic low back pain: a review of the evidence for an American Pain Society/American College of Physicians clinical practice guideline.
Clin Rehabil. 2002 Dec;16(8):811-20.Systematic review of conservative interventions for subacute low back pain.
Aust J Physiother. 2006;52(2):79-88.Specific stabilisation exercise for spinal and pelvic pain: a systematic review.
The Spine Journal Jan-Feb 2008 Interventional Review of What have we learned about the evidence-informed management of chronic low back pain Full Text + Links PDF (179 K)

Wednesday, June 18, 2008

June 2008

BMJ. 2008 Jun 14;336(7657):1351-4. Epub 2008 May 23.
Prolonged conservative care versus early surgery in patients with sciatica from lumbar disc herniation: cost utility analysis alongside a randomised controlled trial.
Spine. 2008 May 20;33(12):E386-93.
Predicting persistent pregnancy-related low back pain.
J Biomech. 2008;41(9):1878-84. Epub 2008 May 22.
Biomechanical model study of pelvic belt influence on muscle and ligament forces.
Chin J Traumatol. 2008 Jun;11(3):135-40.
Radiographic predictors of residual low back pain after laminectomy for lumbar canal stenosis: a minimum of 6-year follow-up.
Spine. 1999 Nov 15;24(22):2313-7.
Seven- to 20-year outcome of lumbar discectomy.
Clin Sports Med. 2008 Jul;27(3):463-79, ix-x.
Clinical prediction for success of interventions for managing low back pain.
Spine. 2008 May 15;33(11):1192-8.
Degeneration of sacroiliac joint after instrumented lumbar or lumbosacral fusion: a prospective cohort study over five-year follow-up.





Posted by at

No comments:

Post a Comment

Subscribe to: Post Comments (Atom)