Transcript of Mechanical low back pain
- 1. MECHANICAL LOW BACK PAINFAIQ AQLI RAZALI (46)AIZAT RUSLIN
(42)MUHAMMAD FAHMI (84)MUHAMMAD HANIF (69)
- 2. Definition Low back pain originating from the disc,
vertebralbody, or posterior elements or might be unrelated tothe
spine. A common musculoskeletal symptom that may beeither acute or
chronic.
- 3. Pathogenesis/ Pathophysiology Many causes of mechanical low
back pain exist. Musculoskeletal causes:1) Nerve root syndromes2)
Musculoskeletal pain syndromes3) Skeletal causes
- 4. Nerve Root Syndromes Classic nerve root syndrome
ischaracterized by radicular painarising from nerve rootimpingement
due to herniateddiscs. Impingement pain tends to besharp, well
localized, and canbe associated withparesthesia, associated with
apositive straight leg raisingsign
- 5. Nerve Root Syndromes Impingement syndrome is most commonly
herniateddiscs, but it may also be caused by spinalstenosis, spinal
degeneration, or cauda equinasyndrome.
- 6. Musculoskeletal Pain Syndromes Musculoskeletal pain
syndromes that produce lowback pain include: Myofascial pain
syndromes characterized by pain and tenderness over localized
areas(trigger points), loss of range of motion in the involved
musclegroups, and pain radiating in a characteristic distribution
butrestricted to a peripheral nerve.
- 7. Musculoskeletal Pain Syndromes Fibromyalgia Pain and
tenderness on palpation of 11 of 18 triggerpoints, one of which is
the low back area, Generalizedstiffness, fatigue, and muscle ache
are reported.
- 8. Skeletal Causes Osteomyelitis Infectious processes involving
thebones of the spine. Sacroiliitis Inflammatory changes in the
sacroiliacjoints. Malignancy Primary or metastatic
- 9. Differential Diagnoses Aneurysm, Abdominal Appendicitis,
Acute Ectopic Pregnancy Endometriosis Neoplasms, Spinal Cord
Ovarian Cysts Pelvic Inflammatory Disease Perirectal Abscess
Prostatitis Renal Calculi Urinary Tract Infection, Female Urinary
Tract Infection, Male
- 10. Acute Mechanical Low Back Pain Most commonly caused by a
sprain or muscle tear. The pain is usually localized, and there may
bemuscle spasms or soreness. The patient usually feels better when
resting.
- 11. Chronic Mechanical Low Back Pain Caused by chronic strain
on the muscles of the lowerback may be caused by obesity;
pregnancy; or job-related stooping, bending, or other
stressfulpostures.
- 12. Treatment of Mechanical Low Back Pain
- 13. Bed Rest & Exercise One or two days of bed rest if
necessary Advice to stay active: There is no evidence that advice
to stay active isharmful for either acute low back pain or
sciatica. Hurt does not equal harm Light activity, avoiding heavy
lifting, bendingor twisting (ie. walking) No data on any particular
exercises
- 14. Medications Anti-inflammatory medications (NSAIDs):
Beneficial (relief pain) , watch side-effects Narcotic Pain
Relievers: More effective than NSAIDs Many side effects Muscle
Relaxants (ie. Flexeril): Can decrease pain and improve mobility
70% with drowsiness/dizziness
- 15. Chiropractic/Osteopathic Spinal manipulation Conflicting
evidence on the effects of spinalmanipulation ~75-90% improvement
anyway within 4 weeks Greater patient satisfaction
- 16. Massage & Physical Therapy1. Might be beneficial2.
Physical therapy modalities:TENS, ultrasound, hot packs,
massage
- 17. THANK YOU