Andrew John Rynne, MD  
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Lower back pain. Never ignore.

Jun 09, 2014 - 2 comments

Back pain




lower back


Lower Back Pain



Low back pain. Some causes and management.

Low back pain is the most frequently reported orthopedic complaint presenting in general practise and to hospital emergency rooms across the world. It can be divided into three different categories for the purpose of description:

Acute lower back pain: This is where the back pain is of sudden onset and is usually associated with some movement or strain such as lifting or pulling or bending down. In the main, rest and simple analgesia is all that is required to fix it. The actual underlying cause may be a pulled muscle, slight disc injury or joint capsular tear. A once off acute lower back pain, that does not radiate down the leg and can be explained on the bases of a strain does not usually warrant any further investigation provided of course that it seems to be resolving over a few days.

Chronic recurring back pain (intractable pain): When back pain becomes a recurring feature of one’s life, when it starts to incur days or weeks out of work, when it radiates down one or both legs, when it keeps the sufferer awake at night and is not responding to the usual analgesics, then investigation is warranted. Today, this investigation will involve an x-ray of lower spine and an MRI scan. Investigation of chronic recurring low back pain will often show up inter-veritable disc damage and/or chronic degenerative changes. In some cases surgery may be required to bring some relief.

Red Flag Lower Back Pain: Because back pain can occasionally signal serious underlying disease like metastatic cancer or serious infection, physicians need to be aware of the back pain that is associated with peculiar circumstances. This requires clinical acumen and judgement. Here are just some of the circumstances that might raise suspicion:

• Back pain occurring in the very young, particularly if not associated with strain or trauma.
• Back pain in one with a history, however distant, of having had cancer.
• Back pain accompanied by unexplained weight loss.
• Pain occurring in the under 18’s or over 50’s with no previous history.
• Pain that does not respond to rest and analgesics..
• Pain that persists for over 6 weeks.
• Night pain.
• Pain radiation down one or both legs. (Sciatica)
• Pain associated with fever and weakness.
• Urinary incontinence or retention associated with back pain.
• Major lower limb muscular wasting associated with back pain.

This is not intended to be an exhaustive list of red flag circumstances that may accompany lower back pain. It is given here only to illustrate the fact that back pain can never be taken for granted and always deserves professional and careful attention to detail.

Psychogenic Back Pain: Back pain for which no explanation can be given after exhaustive investigations may be considered psychogenic. The sufferer feels the pain but the underlying cause may not be organic but rather be caused by stress, anxiety or depression. Also it is worth bearing in mind that chronic back may be used as a pretext to gain sympathy, receive time out of work, receive long-term social benefit payments or court awarded damages.

If you are worried about lower back pain that you or a loved one may be experiencing then we are here to help you with advice and support. It would be our privilege to do so.  

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Avatar universal
by Ashkuhn, Oct 03, 2014
Hello! I have had lower back pain for 3 years now. I am 24 years old and have one child. My back pain prevents me from walking correctly most days. I have a hard time sleeping at night. I have started to get body shakes. At first it was just in my legs and now it's my whole body. I was told by a neurologist that I have pinched nervous in my L5 and L6 or S1. I'm just worried that this isn't going to get better . I've been getting treatment for the whole 3 years, and it's only getting worst. What can I do or should I be worried that this will only ever get worst?

Avatar universal
by sahil148, Oct 08, 2014
ear Doctors,

I am Salih, male, 34, height.5-7, weight 76 kg

I am suffering lower back pain since last 2 years, I work as sales executive and need to drive car regularly.

2 months before my pain goes to worst, mainly the pains are in both side of the hip.I took MRI SCAN , I will explain the scan report here.

Here I am sharing my MRI Lumbar spine scanning report.
# MR imaging reveals lumbar spondylotic changes with

• Diffuse annular bulges L3/L4 & L5/S1 disc indenting thecal sac
• central - left paracentral extrusion L4/L5 disc with mild caudal extension of fragment causing thecal sac and left L5 traversing nerve root compression.

I don’t have any pain in my legs now, I’ve pain in left upper buttock, it may change to right side also sometime. From last one month I started cobra exercise, now I am feeling better and the pain come only after sitting long. I want to know that I can get a permanent solution for my pain with these exercise? Or I should go for surgery ?

Please suggest me the best treatment on above report and how much these reports are serious ?

Also I took treatment for antral ulcer 2 month before, now it's normal too.

Doctors Please Help, Thanks In Advance

If advisable I can send the detailed report as attachment

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