scholarly journals LOW BACK PAIN

2021 ◽  
Vol 2 (1) ◽  
pp. 13-17
Author(s):  
Andaru Cahya S ◽  
Widodo Mardi Santoso ◽  
Machlusil Husna ◽  
Badrul Munir ◽  
Shahdevi Nandar Kurniawan
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Multidisciplinary Approach ◽  
World Population ◽  
Common Symptom ◽  
Low Back ◽  
Red Flags ◽  
Pain Attack ◽  
Primary Health ◽  
Clinical Presentations

Low back pain is the most common symptom found in the primary health care and is the number one cause of disability throughout worldwide. It is estimated that around 60 – 80% the world population will experience back pain during their lifespan. There are three different source of pain in the spine: axial-lumbosacral, radicular and reffered pain. All of these source brings different clinical presentations. Low back pain could be classified as acute, subacute and chronic low back pain. The pain could be nociceptive or neuropathic, the most common symptoms reported are “pressure pain” and “pain attack”. The physician should be aware of “red flags” symptoms that lead into more serious condition beside back pain and, therefore the patient has to be investigated to further examination whenever these symptoms present. The management of low back pain consist of severe modalities, both therapeutic and rehabilitative procedure. Oftentimes, the management needed multidisciplinary approach. It is important to general practitioners to identify and treat low back pain appropriately to reduce the burden of the disease and to prevent the disabilties caused by this condition.

Critical analysis and unique management of Gridhrasi w.s.r. to Sciatica - A Case Report

2018 ◽  
Vol 3 (4) ◽  
Author(s):  
Dr. Rangarajan B. ◽  
Dr. Muralidhara .
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Case Report ◽  
Total Population ◽  
The Body ◽  
Walking Distance ◽  
Common Symptom ◽  
Low Back ◽  
Short Term ◽  
Lower Back

Gridhrasi (Sciatica) is a disorder in which low back pain is found, that spreads through the hip, to the back of the thigh and down the inside of the leg. Mechanical low back pain (LBP) remains the second most common symptom related reason for seeing a physician. 85% of total population will experience an episode of mechanical LBP at some point during their lifetime. Fortunately, the LBP resolves for the vast majority within 2-4 weeks. There are many causes for low back pain, however true sciatica is a symptom of inflammation or compression of the sciatica nerve. The sciatica nerve carries impulses between nerve roots in the lower back and the muscles and nerve of the buttocks, thighs and lower legs. Compression of a nerve root often occurs as a result of damage to one of the discs between the vertebrae. In some cases, sciatic pain radiate from other nerves in the body. This is called referred pain. Pain associated with sciatica often is severe, sharp and shooting. It may be accompanied by other symptom, such as numbness, tingling, weakness and sensitivity to touch. There is only conservative treatment giving short term relief in pain or surgical intervention with side effect. But these are not successful and therefore those who are suffering from this are always in search of result oriented remedy. Walking distance and SLR test were taken for assessment parameter, VAS score was adopted for pain. Before treatment patient was not able to walk even 4 to 5 steps due to severe pain, was brought on stretcher and his SLR was 30° of right side. After 22 days of treatment he was able to walk up to 500 meters without any difficulty, SLR was changed to 60° and patient had got 80 % relief in pain. This case report showed that Ayurvedic protocol is potent and safe in the treatment of Gridhrasi.

Low back pain prevalence and associated factors in nurses from Brazilian primary health units

Work ◽  
2021 ◽  
Vol 70 (1) ◽  
pp. 279-285
Author(s):  
Ricardo Nunes Corrêa Pinto ◽  
Marcelo Cozzensa da Silva ◽  
Eduardo Lucia Caputo ◽  
Marlos Rodrigues Domingues
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Perceived Health ◽  
Individual Characteristics ◽  
Nursing Personnel ◽  
Hospital Environment ◽  
Low Back ◽  
Work Activity ◽  
Primary Health ◽  
Structure Perception

BACKGROUND: Primary health unit (PHU) nursing work is different when compared to hospital environment. Although low back pain (LBP) literature presents studies conducted in hospital nursing personnel, there is a lack of studies in PHU nurses. OBJECTIVE: This study aimed to measure the prevalence of LBP in PHU nursing personnel in the city of Pelotas, Brazil. METHODS: Sociodemographic (age, gender, number of children, skin color, income and marital status), occupational (PHU type, formal education, professional experience, weekly workload, extra work activity, workload perception), nutritional (BMI), health (self-perceived health, smoking, sleep quality and minor psychiatric disorders, PHU physical structure perception) and behavioral (leisure-time physical activity) characteristics were assessed. LBP was defined as pain or discomfort between the last rib and gluteal fold. Poisson regression was used to evaluate the relationship among LBP and covariates. RESULTS: LBP prevalence was 65.2%. Chronic (12 weeks) and acute (7 days) LBP prevalence were 22.4%and 53.4%, respectively. LBP was associated with obesity (PR 1.39 95%CI 1.01–1.92) and poor self-perceived health (PR 2.77 95%CI 1.32–5.80). CONCLUSIONS: Prevalence of LBP in PHU nursing personnel is high and similar to hospital nurses. Individual characteristics such as body mass and health perception were associated with LBP.

scholarly journals Clinical principles for the diagnosis and treatment of musculoskeletal (non-specific) lower back pain

2021 ◽  
Vol 13 (3) ◽  
pp. 107-112
Author(s):  
V. A. Golovacheva ◽  
A. A. Golovacheva ◽  
T. G. Fateyeva
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Combination Therapy ◽  
Interdisciplinary Approach ◽  
Interventional Treatment ◽  
Low Back ◽  
Lumbar Stenosis ◽  
Red Flags ◽  
Lower Back ◽  
Symptoms And Signs

Low back pain (LBP) is one of the most common reasons for a neurologist visit. In 90–95% of cases, LBP is nonspecific (musculoskeletal). The diagnosis of nonspecific LBP based on symptoms, somatic and neurological examination data, the absence of «red flags» (symptoms and signs characteristic of specific causes of back pain, discogenic radiculopathy, or lumbar stenosis). We review the modern principles of acute, subacute, and chronic nonspecific LBP treatment. We also discuss interventional and non-interventional treatment approaches, emphasizing the importance of combination therapy and an interdisciplinary approach.

Re: Limited evidence for screening for serious pathologies using red flags in patients with low back pain presenting to the emergency department

2018 ◽  
Vol 30 (3) ◽  
pp. 437-438 ◽  
Author(s):  
Kirsten Strudwick ◽  
Megan McPhee ◽  
Anthony Bell ◽  
Melinda Martin-Khan ◽  
Trevor Russell
Keyword(s):  
Emergency Department ◽  
Low Back Pain ◽  
Back Pain ◽  
Low Back ◽  
Red Flags ◽  
Limited Evidence

Evaluation of guideline-endorsed red flags to screen for fracture in patients presenting with low back pain

2018 ◽  
Vol 53 (10) ◽  
pp. 648-654 ◽  
Author(s):  
Patricia C S Parreira ◽  
Christopher G Maher ◽  
Adrian C Traeger ◽  
Mark J Hancock ◽  
Aron Downie ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Diagnostic Accuracy ◽  
Older Age ◽  
Diagnostic Study ◽  
Low Back ◽  
Red Flags ◽  
Eligibility Criteria ◽  
Red Flag ◽  
Accuracy Data

Objectives(1) Describe the evolution of guideline-endorsed red flags for fracture in patients presenting with low back pain; (2) evaluate agreement between guidelines; and (3) evaluate the extent to which recommendations are accompanied by information on diagnostic accuracy of endorsed red flags.DesignSystematic review.Data sourcesMEDLINE and PubMed, PEDro, CINAHL and EMBASE electronic databases. We also searched in guideline databases, including the National Guideline Clearinghouse and Canadian Medical Association Infobase.Eligibility criteria for selecting studiesEvidence-based clinical practice guidelines.Data extractionTwo review authors independently extracted the following data: health professional association or society producing guideline, year of publication, the precise wording of endorsed red flag for vertebral fracture, recommendations for diagnostic workup if fracture is suspected, if the guidelines substantiate the recommendation with citation to a primary diagnostic study or diagnostic review, if the guideline provides any diagnostic accuracy data.Results78 guidelines from 28 countries were included. A total of 12 discrete red flags were reported. The most commonly recommended red flags were older age, use of steroids, trauma and osteoporosis. Regarding the evolution of red flags, older age, trauma and osteoporosis were the first red flags endorsed (in 1994); and previous fracture was the last red flag endorsed (in 2003). Agreement between guidelines in endorsing red flags was only fair; kappa=0.32. Only 9 of the 78 guidelines substantiated their red flag recommendations by research and only nine provided information on diagnostic accuracy.Summary/conclusionThe number of red flags endorsed in guidelines to screen for fracture has risen over time; most guidelines do not endorse the same set of red flags and most recommendations are not supported by research or accompanied by diagnostic accuracy data.

scholarly journals Red flag screening for low back pain: nothing to see here, move along: a narrative review

2017 ◽  
Vol 52 (8) ◽  
pp. 493-496 ◽  
Author(s):  
Chad E Cook ◽  
Steven Z George ◽  
Michael P Reiman
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Clinical Practice ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Best Practice ◽  
Negative Likelihood Ratio ◽  
Low Back ◽  
Red Flags ◽  
Red Flag

Screening for red flags in individuals with low back pain (LBP) has been a historical hallmark of musculoskeletal management. Red flag screening is endorsed by most LBP clinical practice guidelines, despite a lack of support for their diagnostic capacity. We share four major reasons why red flag screening is not consistent with best practice in LBP management: (1) clinicians do not actually screen for red flags, they manage the findings; (2) red flag symptomology negates the utility of clinical findings; (3) the tests lack the negative likelihood ratio to serve as a screen; and (4) clinical practice guidelines do not include specific processes that aid decision-making. Based on these findings, we propose that clinicians consider: (1) the importance of watchful waiting; (2) the value-based care does not support clinical examination driven by red flag symptoms; and (3) the recognition that red flag symptoms may have a stronger relationship with prognosis than diagnosis.

scholarly journals Red flags presented in current low back pain guidelines: a review

2016 ◽  
Vol 25 (9) ◽  
pp. 2788-2802 ◽  
Author(s):  
Arianne P. Verhagen ◽  
Aron Downie ◽  
Nahid Popal ◽  
Chris Maher ◽  
Bart W. Koes
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Low Back ◽  
Red Flags

Low back pain – literature review

Ból ◽  
2020 ◽  
Vol 20 (3) ◽  
pp. 51-59
Author(s):  
Marcin Kopka
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Intervertebral Discs ◽  
Prior History ◽  
Low Back ◽  
Red Flags ◽  
Recurrence Rates ◽  
Reduction Of Pain ◽  
History Of ◽  
Optimal Visualization

Low back pain (LBP) is the third most common disorder presenting in the neurology outpatient clinic. It is usually defined as acute (less than 4 weeks), subacute (4–8 weeks) and chronic (more than 12 weeks). It is estimated that lifetime prevalence of up to 84 %. LBP is the most common cause of disability. LBP is divided into musculoskeletal and neurologic low back pain. In 90% of patients under the age of 65 the cause of pain is nerve root compression caused by disk herniation. Although serious spinal pathology is rare (less than 1%), the identification of red flags remains key in the evaluation of patients with LBP. A prior history of cancer, even in the absence of other red flags, has the highest predictive value for detection of malignancy. In conjunction with the history, a careful neurologic examination can help establish the presence and localize the lesion. According to guidelines imaging studies should not be obtained in patients with LBP of less than 6 weeks duration in the absence of red flags. Magnetic resonance imaging is the study of choice in patients with LBP. It allows for optimal visualization of the spinal cord, nerve roots and intervertebral discs. The results of MRI should be interpreted with caution because incidental degenerative spine changes unrelated to the pain are commonly seen in MRI. The main goals of treatment the patients presenting with acute LBP are reduction of pain and preservation of sensory and motor function. In the absence of red flags, for most cases conservative management will be appropriate. Prognosis are favorable, although recurrence rates range from 23% to 80%.

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