Specific Low Back Pain: Difference between revisions
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'''Original Editor '''- Your name will be added here if you created the original content for this page. | '''Original Editor '''- Your name will be added here if you created the original content for this page. | ||
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== Introduction == | == Introduction == | ||
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Serious spinal conditions are very rare but it is important to know about these conditions so that we can adequately screen for them as recommended in international back pain guidelines. | Serious spinal conditions are very rare but it is important to know about these conditions so that we can adequately screen for them as recommended in international back pain guidelines. | ||
#Malignancy | #Malignancy - There are 3 main types of tumors:<br>Primary Tumors – located in either the disc or the boney structures of the spine. <br>Metastatic Tumors – these are secondary tumors which have spread from a primary tumor located elsewhere. Most commonly breast, prostate or lung.<br>Intra and extramedullary Tumors – these are located in (intramedullary) or in the cells surrounding (extramedullary) the spinal Cord.<br>Symptoms can include; Unremitting pain which is uninfluenced by analgesia, severe night pain, neurological deficits, lack of co-ordination of limbs, accompanied with decreased appetite and weight loss.<ref>Greenhalgh S, Selfe J. Red Flags - A Guide to Identifying Serious Pathology of the Spine. Edinburgh: Churchill Livingstone, 2006.</ref><ref>Spine Health - Trusted Information for Back Pain. Types of Spinal Tumors. http://www.spine-health.com/conditions/spinal-tumor/types-spinal-tumors (accessed 6 October 2015)</ref> | ||
#Systemic inflammatory disorders | |||
#Infections | #Systemic inflammatory disorders<br>This includes a number of conditions such as; arthritis, rheumatoid arthritis, infections and Ankylosing Spondylitis (AS). Some of these conditions can be quite challenging to diagnose but can be debilitating such as AS where some parts of the vertebrae can become fused together. Resulting in progressive stiffness as a by-product of inflammation. <ref>Spine Health - Trusted Information for Back Pain. Ankylosing Spondylitis. http://www.spine-health.com/conditions/arthritis/ankylosing-spondylitis (accessed 8 October 2015)</ref><ref>Columbia Neurosurgeons. Spinal Inflammatory Disorders. http://www.columbianeurosurgery.org/conditions/spinal-inflammatory-disorders/ (accessed 8 October 2015)</ref> | ||
#Infections<br>Infections also known as osteomyelitis, discitis or infections in the epidural space (infection in the vertebrae / disc). The most common location for a spinal infection is in the lumbar region (50%) and have been linked to urinary tract infections. Other links have been made to; diabetes, post cardiac / urinary catheterization, drug addiction and of course post spinal surgery. Infections affecting the disc have been shown to have a 40% chance of causing paraplegia and 75-100% of infections involving the epidural space. Although there is low risk of developing an infection it is essential that appropriate treatment is given. Some of the signs and symptoms are pain and those associated with an infection. To accurately diagnose blood cultures will be done to assess Erythrocyte Sedimentaion Rate (ESR), C-reactive Protein (CRP) and White Cell Count (WCC). These are known as inflammatory markers, alongside these appropriate radiography will be done such as an MRI scan.<ref>Greenhalgh S, Selfe J, Red Flags - A Guide to Identifying Serious Pathology of the Spine. Edinburgh: Churchill Livingston, 2006</ref><ref>Spine Health - Trusted Information for Back Pain. Osteomylitis Diagnosis. http://www.spine-health.com/conditions/lower-back-pain/osteomyelitis-diagnosis (accessed 9 October 2015)</ref><ref>American Association of Neurological Surgeons. Spinal Infection. http://www.aans.org/Patient%20Information/Conditions%20and%20Treatments/Spinal%20Infections.aspx (accessed 9 October 2015)</ref> | |||
#Fractures<br> | #Fractures<br> | ||
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#Symptomatic spondylolisthesis<br> | #Symptomatic spondylolisthesis<br> | ||
== Summary == | == Summary == | ||
90% of people will have no clear pathoanatomical diagnosis and an absence of red flags. These people have [[ | 90% of people will have no clear pathoanatomical diagnosis and an absence of red flags. These people have [[Non Specific Low Back Pain|Nonspecific LBP]]. | ||
== Recent Related Research (from [http://www.ncbi.nlm.nih.gov/pubmed/ Pubmed]) == | == Recent Related Research (from [http://www.ncbi.nlm.nih.gov/pubmed/ Pubmed]) == | ||
<rss>Feed goes here!!|charset=UTF-8|short|max=10</rss> | <rss>Feed goes here!!|charset=UTF-8|short|max=10</rss> | ||
== References == | == References == | ||
Revision as of 15:47, 9 October 2015
Original Editor - Your name will be added here if you created the original content for this page.
Top Contributors - Allan D'Hose, Admin, Simisola Ajeyalemi, Richard Benes, Kim Jackson, Leana Louw, Lucinda hampton, Michelle Lee, Jess Bell, Aminat Abolade and Tony Lowe
Introduction[edit | edit source]
Serious or systemic pathology[edit | edit source]
Serious spinal conditions are very rare but it is important to know about these conditions so that we can adequately screen for them as recommended in international back pain guidelines.
- Malignancy - There are 3 main types of tumors:
Primary Tumors – located in either the disc or the boney structures of the spine.
Metastatic Tumors – these are secondary tumors which have spread from a primary tumor located elsewhere. Most commonly breast, prostate or lung.
Intra and extramedullary Tumors – these are located in (intramedullary) or in the cells surrounding (extramedullary) the spinal Cord.
Symptoms can include; Unremitting pain which is uninfluenced by analgesia, severe night pain, neurological deficits, lack of co-ordination of limbs, accompanied with decreased appetite and weight loss.[1][2]
- Systemic inflammatory disorders
This includes a number of conditions such as; arthritis, rheumatoid arthritis, infections and Ankylosing Spondylitis (AS). Some of these conditions can be quite challenging to diagnose but can be debilitating such as AS where some parts of the vertebrae can become fused together. Resulting in progressive stiffness as a by-product of inflammation. [3][4]
- Infections
Infections also known as osteomyelitis, discitis or infections in the epidural space (infection in the vertebrae / disc). The most common location for a spinal infection is in the lumbar region (50%) and have been linked to urinary tract infections. Other links have been made to; diabetes, post cardiac / urinary catheterization, drug addiction and of course post spinal surgery. Infections affecting the disc have been shown to have a 40% chance of causing paraplegia and 75-100% of infections involving the epidural space. Although there is low risk of developing an infection it is essential that appropriate treatment is given. Some of the signs and symptoms are pain and those associated with an infection. To accurately diagnose blood cultures will be done to assess Erythrocyte Sedimentaion Rate (ESR), C-reactive Protein (CRP) and White Cell Count (WCC). These are known as inflammatory markers, alongside these appropriate radiography will be done such as an MRI scan.[5][6][7] - Fractures
LBP with significant neurological deficits[edit | edit source]
- Cauda equina syndrome
- Sciatica due to symptomatic disc
- Prolapse or lateral canal stenosis
- Central stenosis
- Symptomatic spondylolisthesis
Summary[edit | edit source]
90% of people will have no clear pathoanatomical diagnosis and an absence of red flags. These people have Nonspecific LBP.
Recent Related Research (from Pubmed)[edit | edit source]
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References[edit | edit source]
References will automatically be added here, see adding references tutorial.
- ↑ Greenhalgh S, Selfe J. Red Flags - A Guide to Identifying Serious Pathology of the Spine. Edinburgh: Churchill Livingstone, 2006.
- ↑ Spine Health - Trusted Information for Back Pain. Types of Spinal Tumors. http://www.spine-health.com/conditions/spinal-tumor/types-spinal-tumors (accessed 6 October 2015)
- ↑ Spine Health - Trusted Information for Back Pain. Ankylosing Spondylitis. http://www.spine-health.com/conditions/arthritis/ankylosing-spondylitis (accessed 8 October 2015)
- ↑ Columbia Neurosurgeons. Spinal Inflammatory Disorders. http://www.columbianeurosurgery.org/conditions/spinal-inflammatory-disorders/ (accessed 8 October 2015)
- ↑ Greenhalgh S, Selfe J, Red Flags - A Guide to Identifying Serious Pathology of the Spine. Edinburgh: Churchill Livingston, 2006
- ↑ Spine Health - Trusted Information for Back Pain. Osteomylitis Diagnosis. http://www.spine-health.com/conditions/lower-back-pain/osteomyelitis-diagnosis (accessed 9 October 2015)
- ↑ American Association of Neurological Surgeons. Spinal Infection. http://www.aans.org/Patient%20Information/Conditions%20and%20Treatments/Spinal%20Infections.aspx (accessed 9 October 2015)
