Low back pain – literature review

Ból ◽  
2020 ◽  
Vol 20 (3) ◽  
pp. 51-59
Author(s):  
Marcin Kopka

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%.

2019 ◽  
Vol 22 (11) ◽  
pp. 1206-1212 ◽  
Author(s):  
Eduardo Martinez-Valdes ◽  
Fiona Wilson ◽  
Neil Fleming ◽  
Sarah-Jane McDonnell ◽  
Alex Horgan ◽  
...  

2020 ◽  
Vol 39 (04) ◽  
pp. 300-305
Author(s):  
Ana Carla Schimidt ◽  
Paula de Oliveira Herzinger ◽  
Danielle Pacheco Matias ◽  
Leonardo C. Welling

AbstractLow back pain is defined as pain located between the lower rib cage and the gluteal folds, and its etiology is multifactorial, considerably affecting quality of life. The aim of this literature review was to analyze the influence of the Pilates method on the symptoms of patients with nonspecific low back pain, which is considered a promising treatment for this type of pathology. A narrative review of the literature was carried out using the PubMed, Pedro, Scopus and Scielo databases. To perform the search, Pilates AND Low back nonspecific AND Pain were used as keywords. Articles published in the last 5 years, randomized clinical trials that verified the influence of the Pilates method in adult individuals with unspecified low back pain and full text in English were included. Of the 77 articles identified, 7 articles met the inclusion criteria, 7 analyzed the primary outcomes of pain intensity and disability, 5 articles compared Pilates with other rehabilitation techniques and 2 studies compared the effectiveness of Pilates solo with Pilates apparatus. It was concluded that all the techniques that were compared with Pilates are effective, being difficult to affirm the superiority of Pilates over them in relation to the reduction of pain and disability and improvement of quality of life. However, the Pilates method has shown good results in pain perception and intensity, functional capacity, fear of movement and the idea that movement can worsen your condition, muscle strength, range of motion and flexibility.


2018 ◽  
Vol 25 (6) ◽  
pp. 583-596 ◽  
Author(s):  
Michael Lukas Meier ◽  
Andrea Vrana ◽  
Petra Schweinhardt

Motor control, which relies on constant communication between motor and sensory systems, is crucial for spine posture, stability and movement. Adaptions of motor control occur in low back pain (LBP) while different motor adaption strategies exist across individuals, probably to reduce LBP and risk of injury. However, in some individuals with LBP, adapted motor control strategies might have long-term consequences, such as increased spinal loading that has been linked with degeneration of intervertebral discs and other tissues, potentially maintaining recurrent or chronic LBP. Factors contributing to motor control adaptations in LBP have been extensively studied on the motor output side, but less attention has been paid to changes in sensory input, specifically proprioception. Furthermore, motor cortex reorganization has been linked with chronic and recurrent LBP, but underlying factors are poorly understood. Here, we review current research on behavioral and neural effects of motor control adaptions in LBP. We conclude that back pain-induced disrupted or reduced proprioceptive signaling likely plays a pivotal role in driving long-term changes in the top-down control of the motor system via motor and sensory cortical reorganization. In the outlook of this review, we explore whether motor control adaptations are also important for other (musculoskeletal) pain conditions.


2020 ◽  
Vol 29 (4) ◽  
pp. 400-404 ◽  
Author(s):  
Whitney Williams ◽  
Noelle M. Selkow

Context: Decreased hamstring flexibility can lead to a plethora of musculoskeletal injuries, including low back pain, hamstring strains, and patellofemoral pain. Lack of flexibility may be the result of myofascial adhesions. The fascia connected to the hamstrings is part of the superficial back line that runs from the cranium to the plantar aspect of the foot. Any disruption along this chain may limit the flexibility of the hamstring. Objective: To investigate if self-myofascial release (SMR) of the plantar surface of the foot in addition to the hamstring group was more effective at improving the flexibility of the hamstrings when compared with either intervention alone. Design: Cross-over study. Setting: Athletic training facility. Participants: Fifteen college students (5 males and 10 females; age: 20.9 [1.4] y, height: 173.1 [10.3] cm, mass: 80.0 [24.9] kg) who were not older than 30, with no history of low back pain or injury within the past 6 months, no history of leg pain or injury within the past 6 months, no current signs or symptoms of cervical or lumbar radicular pain, no current complaint of numbness or tingling in the lower-extremity, and no history of surgery in the lower-extremity or legs. Interventions: Each participant received each intervention separated by at least 96 hours in a randomized order: hamstring foam rolling, lacrosse ball on the plantar surface of the foot, and a combination of both. Main Outcome Measures: The sit-and-reach test evaluated hamstring flexibility of each participant before and immediately after each intervention. Results: There were no significant differences found among the SMR techniques on sit-and-reach distance (F2,41 = 2.7, P = .08, ). However, at least 20% of participants in each intervention improved sit-and-reach distance by 2.5 cm. Conclusions: SMR may improve sit-and-reach distance, but one technique of SMR does not seem to be superior to another.


2008 ◽  
Vol 65 (7) ◽  
pp. 507-511 ◽  
Author(s):  
Slobodan Culafic ◽  
Dara Stefanovic ◽  
Dragan Dulovic ◽  
Ljubodrag Minic ◽  
Andrijana Culafic

Background/Aim. Low back pain is one of the most common painful conditions in the modern age. Therefore, it is very important to establish the most effective protocol for the treatment of this condition. The aim of this study was to find out if fluoroscopically, guided epidural procainecorticosteroid injection is effective in the treatment of degenerative chronic low back pain. Methods. This prospective cohort study was performed in the Military Medical Academy from September 2005 to June 2006 and included 60 patients of both sexes, 34-85 years of age. Degenerative changes of lumbosacral spine were determined by magnetic resonance imaging. The intensity of low back pain was evaluated by subjective (Roland's scale) and objective parameter (Lazarevic sign). Epidural procaine-corticosteroid injection was applied in the patients with low back pain not responding to conservative therapy. After the application of injection, effects of the therapy were followed up. Results. In 92% of the patients there was a reduction of pain intensity for three months, in 4.8% a reduction for a month, but after another injection they felt pain reduction for the next three months. One patient (2.3%) had pain reduction for one month. Conclusion. In the treatment of degenerative chronic low back pain, not responding to conservative therapy with nonsteroidal anti-inflammatory drugs, epidural procaine-corticosteroid injection have a satisfactory short-term as well as a long-term analgesic effect.


2021 ◽  
Vol 2 (1) ◽  
pp. 13-17
Author(s):  
Andaru Cahya S ◽  
Widodo Mardi Santoso ◽  
Machlusil Husna ◽  
Badrul Munir ◽  
Shahdevi Nandar Kurniawan

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.


2017 ◽  
Vol 13 (24) ◽  
pp. 267
Author(s):  
Kodjo Kakpovi ◽  
Komi Cyrille Tagbor ◽  
Eyram Fianyo ◽  
Agbeko Komlan Doleagbenou ◽  
Kokou Mensah Guinhouya ◽  
...  

Objective: To determine the prevalence and factors associated with neuropathic pain in patients with non-specific low back pain. Methods: This was a cross-sectional study conducted from May to July 2016 in the Rheumatology, Neurology and Neurosurgery departments of Lome. The DN4 questionnaire was used for the diagnosis of neuropathic pain in the 200 patients with low back pain included in this study. Results: Of the 200 patients (147 women and 53 men) included in the study, neuropathic pain was present in 92 (46%). The average age of the 92 patients (67 women vs 25 men, p = 0.04) was 55.5 ± 12.4 years (women 55.2 ± 12.8 vs. men 54.6 ± 11.4, p = 0.5). The characteristics of neuropathic pain mainly found were: burning sensation (n = 67, 72.8%); electrical discharges (n = 64, 69.6%); tingling (n = 90; 97.8%); tickling (n = 57; 62%); numbness (n = 89; 96.7%); hypoesthesia (n = 52; 56.5%). Factors significantly associated with the presence of neuropathic pain in LBP were age (p = 0.005), duration of LBP (p = 0.04), high blood pressure (p = 0.001), radicular pain (p = 0.00002) and the past history of the LBP (0.000000). Conclusion: Neuropathic pain is common in patients with LBP at Lome. The duration of LBP, past history of LBP, previous NSAID use, BMI, pain severity and radicular pain appear to be predictive of the occurrence of these neuropathic pains.


2021 ◽  
Vol 13 (3) ◽  
pp. 107-112
Author(s):  
V. A. Golovacheva ◽  
A. A. Golovacheva ◽  
T. G. Fateyeva

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.


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