Please e-mail to me if you wish to know more about Physiotherapy or Medical Information. eyckle@hkstar.comCommon Causes of low back pain
1. Sprains of the ligaments or muscle around the vertebral body of the low back,eg. during sport activities or accident,
2. Prolapse of intervertebral disc. There is a disc between vertebral bodies. As the degenerating changes or injuries of the vertebral body, the nucleus pulposus in the disc prolapse or extrude backwards. It extrudes or protrudes towards the spinal nerves and pressurizes the spinal nerve root. Then, it causes pain commonly known as sciatica.
3. Arthritis. It usually happens after you are 50. In degenerating process and prolonged improper posture/activities, it will cause degenerative arthritis (Osteoarthris). Besides, rheumatoid arthritis, ankylosing spondylitis also cause low back pain.
4. Fracture or dislocation of vertebral bodies. For example, traffic accident or fall in the elderly. If it is severe compressed the spinal cord, the patient will be paralyzed and become paraplegia. If there is a person who suffers fracture or dislocation of the low back and you are not received medical training (e.g . doctors, nurses or first aiders) before, you should not move or treat the person. In the older and degenerating process, there is some unknown fracture happened.
5. Spondylolysis ( ¯á ´Õ ¸Ñ Â÷ ) or spondylolisthesis ( ¯á´Õ«e²¾). It is due to the congenital disorders or vertebral body under unknown injuries. This causes vertebral move forwards (spondylolysis) and if it is severe, it will compress the spinal nerves. This will cause spndylolisthesis. 6. Infection. It is coming from the blood. For example, tuberculosis (ªÍ À÷) of the spine or pyogenic (staphylococcus, ¸² µå²yµß¡^.
7. Congenital disorders. For example, spinal bifida ( ¯á¬Wµõ).
8. Tumor ( ¸~½F) . It is divided into benign and malignant. Also, the tumor can be primary (coming from the vertebral body) or secondary (coming from other organs).
9. Psychological problems. It is due to work pressure, stressful mind.
10. Poor posture. Poor posture of sitting/ standing position , repetitive actions of heavy lifting, inproper sport activities, obesity, poor sleeping habit, poor shoes or poor sleeping beds or pillows cause low back pain.
11. Others. Other organs eg. kidneys, gall bladder, or gynaeological problems can refer the pain towards low back.
Signs or symptoms of low back pain
1. Soreness pain or tightness of the back muscle
2. Stiffness of the back
3. Referred pain down to the thigh, the knee or the buttock.
4. Nerve root compression.
- pain at the thigh, knee or buttock down to the ankle
- pin and needles or numbness of the thigh knee or buttock down to the ankle
- muscle weakness of the leg muscle or back muscles
- decrease sensation of the back, thigh, knee or buttock down to the ankle
5. Decrease in the range of movement of the spine.
6. Paraplegia cases.
- pain at both legs, no sensation of both legs
- incontinence
- unable to perform movement of the legs and lose control or balance
Diagnosis
1. History of the patients. eg. occupation, habbit or past medical histories.
2. Physical examination eg, deformities of the vertebral bodies of the back, posture, range of movement and muscle power of the back and legs,
3. X-rays. It can diagnose fracture, dislocation, spondylolysis or spondylolisthesis.
4. CT Scan/Myelography. Clear image of the problems between the vertebral body and the spinal nerves.
5. Others investigations. For example, complete blood picture CBP, and erythrocyte sedimentation rate ESR), and electromyogram or biopsy.
Treatment method
1. Bedrest. This can reduce further deterioation of the problems.
2. Medication. After making diagnosed by doctors, analgesic drugs, sedatives drugs can relieve the pain. Sometimes, antibiotic drugs or other medical is needed to treat the causes e.g Tuberculosis.
3. Physiotherapy. According to the problems of the patients, physiotherapist delivers treatments, eg. traction, electrotherapy, exercise or hydrotherapy to cure the pain and gives the advice on prevention of the recurrence of the low back pain
4. Surgery. If the case is severe and diagnosed by the doctors, the patients will need further surgery intervention, eg, laminectomy or spinal fusion.
5. Psychological therapy by psychologist.
6. Others. Referred pain from others organs is treated the cause coming from these organs.
7. Tumours. It is treated with radiotherapy or chemotherapy.
Please e-mail to me if you wish to know more about Physiotherapy or Medical Information. eyckle@hkstar.com
