scholarly journals Diagnostic Approaches to a Patient with the Problem of Acute Low Back Pain at the Family Doctor’s Practice (According the Experience of Croatia and Slovenia)

2021 ◽  
pp. 24-27
Author(s):  
Liliia Babynets ◽  
Iryna Halabitska
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Family Doctor ◽  
Diagnostic Process ◽  
Low Back ◽  
Permanent Disability ◽  
Acute Low Back Pain ◽  
Number Of Patients ◽  
The Family

Acute low back pain is one of the most common health problems in family medicine. This pain is experienced at least once in the life of 60–80 % of people. The aim is to study the European (Croatian and Slovenian) experience of the diagnostic approach to the management of a patient with the problem of acute low back pain in the practice of a family doctor. Acute low back pain is the reason for frequent visits to the family doctor. Most patients are diagnosed with uncomplicated low back pain, which does not require additional diagnostic tests, and a course of treatment and a short hospital stay (up to two weeks) is prescribed by a family doctor. Back pain is not a definitive diagnosis. This may be a reason to visit or as a working syndrome diagnosis. To determine the cause of pain, it is necessary to determine the source of pain in order to select the appropriate treatment for the patient. To identify the cause it is necessary to collect history and conduct clinical examinations for the following factors: uncomplicated low back pain, radicular back pain, severe pathology of the lumbosacral region, pain from related structures, psychosocial factors (somatization, exacerbation). A small number of patients with acute low back pain develop chronic low back pain, which is established as a diagnosis after clinical symptoms persist for six months. It is important to immediately diagnose patients who may initially develop chronic low back pain, which requires referral for additional diagnostic examination, physical therapy, and to assess for temporary or permanent disability. Carrying out the diagnostic process according to the above algorithm allows to determine the causative factor of acute low back pain, which will prescribe an effective and rational scheme of such a patient to correct the clinical condition, relieve pain and prevent chronic low back pain.

Therapeutic and organizational approaches to the patients with acute back pain management in outpatient practice (according experience of Croatia and Slovenia)

2021 ◽  
Vol 2021 (2) ◽  
pp. 28-32
Author(s):  
L.S. Babinets ◽  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Pain Relief ◽  
Chronic Back Pain ◽  
Family Doctor ◽  
Low Back ◽  
Permanent Disability ◽  
Acute Low Back Pain ◽  
Number Of Patients ◽  
Acute Back Pain

Acute low back pain is one of the most common health problems in family medicine. This pain is experienced at least once in the life of 60-80% of people. The aim is to analyze the European (Croatian and Slovenian) experience of medical and organizational approach to the management of a patient with acute back pain in the practice of a primary care physician. Main part. Treatment of low back pain should be comprehensive and not only pharmacological. An appropriate combination with other treatments is required. The patient should be well aware of the nature of his illness. In more patients, a course of treatment and a short hospital stay (up to two weeks) is prescribed by a family doctor. The main purpose of drug treatment is pain relief. Treatment begins with paracetamol, which effectively relieves low back pain, while side effects are very rare. If the effect is weak, use nonsteroidal anti-inflammatory drugs (not recommended for patients with gastric or duodenal ulcers). A small number of patients with acute low back pain develop chronic back pain, which is established as a diagnosis after clinical symptoms persist for six months. It is important to immediately diagnose patients who may initially develop chronic low back pain, which requires referral for additional diagnostic examination, physical therapy, and assessment for temporary or permanent disability. Conclusion: Acute low back pain is a disease in which more than 50% of patients recover within 14 days. 10% of them have chronic pain. Such patients put a serious burden on the family doctor and the health insurance system. These 10% of patients spend almost 90% of the resources allocated to the treatment of low back pain. Diagnosis of acute low back pain should be thorough, which will appoint an effective and rational scheme of management of such a patient in order to correct the clinical condition, pain relief and prevention of chronic acute back pain

scholarly journals Is single-point acupuncture effective in treating acute low back pain? A case report

2021 ◽  
Author(s):  
Sagun Tiwari ◽  
Namrata Sapkota
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Case Report ◽  
Adverse Events ◽  
Chronic Low Back Pain ◽  
Single Point ◽  
Low Back ◽  
Acute Low Back Pain ◽  
Short Time

Acupuncture is often used for acute and chronic low back pain; however, its efficacy is controversial, primarily for acute low back pain (ALBP). Our case study suggests that single acupuncture could relieve ALBP within a short time without any adverse events.

Design Implementation and Analysis of a Universal Lumbosacral Support Device to Prevent Low Back Pain in Motorized Two-Wheeler Riders

2017 ◽  
Author(s):  
Krishna Pedaprolu ◽  
Satyam Rajput ◽  
Sharmila Nageswaran
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Lower Back Pain ◽  
Chronic Low Back Pain ◽  
Compression Fracture ◽  
The Body ◽  
Low Back ◽  
Persistent Symptoms ◽  
Acute Low Back Pain ◽  
Lower Back

According to National Institute of Neurological Disorders and Stroke (NINDS), a division of National Institutes of Health (NIH), about 80% adults suffer from low back pain at some point in time and about 2 out of 10 people who are affected by acute low back pain develop chronic low back pain with persistent symptoms at one year [1]. Though in some cases, treatment does relieve chronic low back pain, but in other cases, pain persists despite treatment. Mostly, the lower back pain is of mechanical nature, i.e., disruption in the way the components of the back (the spine, muscle, intervertebral discs, and nerves) fit together and move. The causes of lower back pain can be imputed to various conditions such as sprains and strains, osteoarthritis, herniated discs, whiplash, compression fracture, scoliosis, stenosis, inflammation of joints, osteoporosis. It not only causes pain, but also severs the economy of a nation. It is a major contributor to missed workdays [1]. Research indicates that the total indirect costs due to back pain accrue to more than $100 billion annually [2]. Not many people can afford traveling by car or taxi to office, especially in developing countries and in cities with high traffic, where people prefer to travel by two-wheelers for their access to work and other amenities. However, people with lumbar problems are recommended not to use two-wheelers as the movement of the body on uneven roads or while braking/accelerating may increase the pain and discomfort. This reduces the productivity of not only the individual and the firm but also the productivity of the country as a whole.

scholarly journals A krónikus derékfájdalom korszerű diagnosztikája és kezelése a nemzetközi irányelvek tükrében

2021 ◽  
Vol 162 (49) ◽  
pp. 1951-1961
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Treatment Guidelines ◽  
The United States ◽  
Chronic Lower Back Pain ◽  
Evidence Based ◽  
Low Back ◽  
Agree Ii ◽  
Acute Low Back Pain

Összefoglaló. Nemzetközi kutatások szerint a deréktáji fájdalom 2019-ben 568 millió embert érintett világszerte. Magyarországon a lakosság 20%-a él krónikus derékfájdalommal, ami nemcsak egészségügyi, de szociális és ökonómiai krízist is jelent. A probléma aktualitását jól mutatja az is, hogy a Nemzetközi Fájdalomkutatási Társaság a 2021. évet a derékfájdalomról szóló globális évnek kiáltotta ki. A derékfájdalmak megfelelő kezelése és a krónikussá válás megelőzése tehát kiemelten fontos. Ebben nyújthatnak segítséget az evidenciákon alapuló irányelvek. Magyarországon azonban jelenleg nincs hatályos, egységes irányelv, mely a derékfájdalmakkal, azon belül is a krónikus derékfájdalom kezelésével foglalkozna. A jelen közleményben a krónikus derékfájdalom evidenciákon alapuló diagnosztikai és kezelési lehetőségeinek áttekintését tűztük ki célul. Az irodalomkutatást követően, a jelenleg is hatályos, AGREE II. rendszer szerinti magas minőségű besorolást elérő, krónikus deréktáji fájdalomra vonatkozó, angol nyelvű nemzetközi irányelvek ajánlásainak összehasonlítását végeztük el. Tanulmányunkban hét irányelvet dolgoztunk fel (négy európai, kettő amerikai, egy kanadai), melyek mindegyikében a következő közös ajánlások kerültek megfogalmazásra: a súlyos patológiák kizárása az alarm tünetek alapján, a pszichoszociális tényezők figyelembevétele, a szükségtelen képalkotó vizsgálat visszaszorítása, az elsősorban aktív, nem gyógyszeres terápiák preferálása és a nemszteroid gyulladáscsökkentők körültekintő felírása. Az európai irányelvekben új elemként szerepelt a krónikussá válás korai rizikóbecslése. Orv Hetil. 2021; 162(49): 1951–1961. Summary. In 2019, low back pain caused the highest burden globally, among musculoskeletal disorders, affecting 568 million people. According to Hungarian sociodemographic data, 20% of the Hungarian adults live with chronic low back pain that is a global health priority. Therefore, the International Association for the Study of Pain announced 2021 as the global year about back pain. Evidence-based guidelines about the appropriate treatment of acute low back pain and prevention of chronic low back pain are therefore of paramount importance. However, there are currently no valid, uniform treatment guidelines in Hungary about acute and chronic lower back pain. In this paper, we aimed at summarizing up-to-date, evidence-based diagnostic and treatment recommendations for chronic low back pain. Using a literature review, we identified seven international treatment guidelines (four from Europe, two from the United States and one from Canada) in English for the management of chronic low back pain that were previously assessed by the AGREE II quality assessment tool. We found consistent recommendations in the guidelines such as exclusion of alarm symptoms, assessment of psycho-social factors, reduction of unnecessary imaging, initialization of primarily active, non-pharmacological therapies, and careful and cautious prescription of non-steroidal anti-inflammatory medications. A new recommendation in the European guidelines is the early risk assessment of low back pain becoming chronic. Orv Hetil. 2021; 162(49): 1951–1961.

scholarly journals Development and validation of a screening tool to predict the risk of chronic low back pain in patients presenting with acute low back pain: a study protocol

BMJ Open ◽  
2015 ◽  
Vol 5 (7) ◽  
pp. e007916 ◽  
Author(s):  
Adrian Traeger ◽  
Nicholas Henschke ◽  
Markus Hübscher ◽  
Christopher M Williams ◽  
Steven J Kamper ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Study Protocol ◽  
Chronic Low Back Pain ◽  
Screening Tool ◽  
Low Back ◽  
Acute Low Back Pain ◽  
Development And Validation

scholarly journals POS1289 CHRONIC LOW BACK PAIN: THERAPEUTIC STRATEGIES AND CLINICAL OUTCOMES IN A MILITARY POPULATION

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 926.2-926
Author(s):  
R. Dhahri ◽  
A. Dghaies ◽  
M. Slouma ◽  
L. Metoui ◽  
I. Gharsallah ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Lumbar Spine ◽  
Physical Examination ◽  
Chronic Low Back Pain ◽  
Radicular Pain ◽  
Abdominal Muscles ◽  
Low Back ◽  
Number Of Patients ◽  
The Impact

Background:Low back pain is an extremely common patient complaint. Most cases resolve quickly after the acute episode. However, a significant number of patients develop chronic low back pain; a persistent disabling condition. Patients suffer from unremitting pain and often become functionally impaired.Objectives:The aim of this study is to describe the characteristics of chronic LBP, physical examination abnormalities, treatment strategies and the impact of LBP on the professional life of the patients.Methods:It was a an analytical cross-sectional study including 50 patients with at least three months of LBP, in the department of rheumatology and orthopedics at the Military Hospital of Tunis between January 1st and March 31, 2020. All patients had a standardized investigation and clinical assessment.Results:The study included 80% of active military serving members and 20% of administrative officers. The mean age of the patients was 41.9 ± 8.4 years and the sex ratio was 4.5. Four patients were suffering from diabetes; two patients were suffering from high blood pressure. All the patients were suffering from chronic LBP lasting for an average of 66.4 months. LBP was associated with radicular pain in 78% of the cases. It was a unilateral radicular pain in 72% of the cases and bilateral in 28% of the cases. The main triggering factors were: carrying heavy loads in 98% of the cases, standing or sitting for long periods in 90% and 76% of the cases, tremors in 74% of the cases. Neuropathic pain was found in 26% of patients. Physical examination showed paravertebral muscle tenderness in 66% of the cases and slack abdominal muscles in 56% of the cases. Assessement of range of flexion of the lumbar spine showed: fingertip to floor test was 18 ±12.2 cm [054cm], schober test was +3.8±1.2cm [16cm]. The extension of lumbar spine was painful in 80% of the cases. A trigger point was found in 28% of the cases. Lasegue sign was positive in 18% of the cases. Leri’s test was positive in 8% of the cases. Required treatments during the last episode of LBP were: Paracetamol (62%), nonsteroidal antiinflammatory drugs (26%), tramadol (4%), myorelaxant (4%) and pregabalin (2%). Half of the patients needed functional rehabilitation. Forty percent of the patients reported improvement; 46% of them reported improvement then recurrence of the pain, 8% of them reported no improvement and 4% reported worsening of the symptoms. Thirty six percent of the patients needed an average of 21 days of leave and 35% of them needed exemption from work for LBP problems. One patient needed an outplacement from his original work and one patient needed an early retirement.Conclusion:Chronic low back pain can cause significant functional disability, and commonly becomes frustrating for both patients and physicians to cope with and treat. There is still no consensus on the best way to manage chronic low back pain, and clinical guidelines are scarce. A combination of pharmacological agents and non-pharmacological methods is the most appropriate therapeutic regimen.Disclosure of Interests:None declared

scholarly journals MECHANISM OF VERTICAL POSTURE FORMATION AND PARAMETERS OF SAGITTAL SPINOPELVIC BALANCE IN PATIENTS WITH CHRONIC LOW BACK PAIN AND SCIATICA

2006 ◽  
pp. 061-069 ◽  
Author(s):  
Aleksandr Ivanovich Prodan ◽  
Vladimir Aleksandrovich Radchenko ◽  
Aleksey Nikolayevich Khvisyuk ◽  
Vladimir Aleksandrovich Kutsenko
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Lumbar Spine ◽  
Chronic Low Back Pain ◽  
Sacral Slope ◽  
Vertical Posture ◽  
Protective Mechanism ◽  
Low Back ◽  
Number Of Patients ◽  
Spinopelvic Balance

Objective.To study parameters of sagittal spinopelvic balance in patients with chronic low back pain and sciatica, and mechanism of vertical posture formation in a sagittal plane.Material and Methods.Total of 100 patients (32 female and 68 male, mean age 38.7 years) with chronic low back pain and sciatica underwent clinical and radiological examinations. Pelvic incidence (PI), sacral slope (SS), pelvic tilt (PT), and global lumbar lordosis (GLL) were measured on lateral standing radiograms. Statistical analysis of the obtained data was performed.Results.The mean value of PI (50.7°) in patients with back pain and sciatica and in healthy volunteers was almost equal, while SS and GLL were significantly lower in patients, and PT – higher, than those in volunteers. Number of patients with PI ≤ 35 was significantly higher than that of volunteers. Pearson’s correlation coefficient between GLL and PI was 0.916, between GLL and SS – 0.902, and between GLL and PT – 0.326. Vertical posture in patients with chronic low back pain and lumbar sciatica is characterised by backward pelvic rotation relative to hip and by hypolordotic shape of the lumbar spine.Conclusion.Vertical posture in patients with low back pain and sciatica is determined by a backward rotation of the pelvis, therefore SS and GLL decrease, and PT increases. A prevalence of extremely low values of PI (≤35°) may be considered as a risk factor for lumbar spine degenerative diease. Alteration of vertical posture is a kind of protective mechanism.

scholarly journals A derékfájás: mikor és mit tegyünk?

2015 ◽  
Vol 156 (33) ◽  
pp. 1315-1320 ◽  
Author(s):  
S. Tamás Illés
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Behavioral Therapy ◽  
Day Treatment ◽  
Therapeutic Process ◽  
International Standards ◽  
Low Back ◽  
Permanent Disability ◽  
Acute Low Back Pain ◽  
Active Mobilization

The low back pain has become one of the greatest public health problems worldwide. The author based on the current international standards summarizes the knowledge necessary for every day treatment of low back pain. In acute low back pain the author underlines the necessity of the rapid, accurate diagnosis and separation for specific and non-specific low back pain. In specific acute low back pain the treatment should focus on to eliminate the root causes. In non-specific cases pain killing treatment and early active mobilization is the choice for the therapeutic process. Beside analgesia, the primary goal of the treatment is to prevent becoming chronic the symptomatology. Objectives of the management of chronic low back pain are effective pain reduction, continuous maintainance of physical activity, prevention of permanent disability, and restoration of working ability. Analgesics, non steroid anti-inflammatory drugs, and muscle relaxants reduce pain, while multidisciplinary management programs, personalized and guided physiotherapy, cognitive behavioral therapy, as well as short training programs will help to restore function. Surgical treatment is only indicated in degenerative cases and only after the failure of conservative therapy. Orv. Hetil., 2015, 156(33), 1315–1320.

scholarly journals The Biomechanics of the Lumbosacral Region In Acute And Chronic Low Back Pain Patients

2008 ◽  
Vol 4;11 (8;4) ◽  
pp. 505-511
Author(s):  
Güldal Funda Nakipoglu
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Lumbar Lordosis ◽  
Low Back ◽  
Lumbosacral Region ◽  
Acute Low Back Pain ◽  
Significant Difference ◽  
Segmental Lordosis ◽  
Pain Patients

Background: A previous study examined the relationship between the sacral inclination angle (SIA), lumbosacral angle (LSA) and sacral horizontal angle (SHA) and spinal mobility in acute low back pain and chronic low back pain patients. We chose to investigate the lumbar lordosis angle, segmental lumbar lordosis angle, SIA, LSA and SHA in acute and chronic low back pain (LBP) patients as well as the correlation between spinal stability and these angles. Objectives: To investigate the biomechanics of the lumbosacral spine region in acute and chronic LBP patients, as well as to examine the correlation between spinal stability and lumbosacral angles. Study Design: Randomized controlled evaluation Setting: Physical Medicine and Rehabilitation outpatient clinic Methods: Sixty participants with LBP were recruited and categorized as either acute LBP (pain < 3 months) or chronic LBP (pain > 6 months), with 30 subjects in each group. All subjects underwent standing, lateral lumbosacral x-rays, which were analyzed for lumbar stability, SIA, LSA, SHA, lumbar lordosis angle and segmental lumbar lordosis angles. Results: The mean age of the ALBP subjects was 41.00 ± 11.63 (18 – 66) and that of the chronic LBP subjects 49.26 ± 15.6 (22-74), with females comprising 50% of the acute LBP group and 73.3% of the chronic LBP group. Lumbar stability was observed in 62.1% of acute LBP patients and 36.8% of chronic LBP patients. A statistically significant difference was found between the 2 groups in terms of age, gender, and lumbar stability. There was no statistical difference regarding SIA, LSA, SHA, total and segmental lordosis angles between acute and chronic LBP patients (p>0.05). Conclusion: We were unable to find a difference between the radiological values for the shape of the SIA, LSA, SHA, and total and segmental lordosis as noted on screening x-ray techniques regarding the occurrence of acute or chronic LBP, but a statistically significant difference was found for lumbar stability. Further extensive studies are needed to examine lumbar stability and its relationship between angles of lumbosacral region. Key words: biomechanic, acute low back pain, chronic low back pain, lumbar stability, lumbosacral, sacral, lumbar lordosis

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