-IBIS-1.5.0-
tx
musculoskeletal system
low back pain
diagnoses

definition and etiology

definition: Pain felt either in the lumbar, lumbosacral, or sacroiliac areas.

etiology: Most LBP is from degenerative joint disease in the lumbosacral region, poor posture; the "beer belly"; constipation; and stress-induced myospasms of the lumbosacral region. LBP is commonly associated with sciatica.

signs and symptoms

signs and symptoms:
Usually, onset is gradual. If acute, then there is probably a traumatic cause.

• Pain: May radiate.
• Tenderness with muscle spasms and inflammation evident upon palpation.
• Decreased ROM.
• Musculoskeletal exam checking for landmarks, vertebral malposition etc.

lab findings:
• CT scan.
• X-rays.
• CSF analysis.
• Appropriate tests if another organ system is thought responsible for the pain (e.g. UA for kidney involvement).

course and prognosis

The prognosis depends on the cause. Generally, the condition is benign and the prognosis is excellent with comprehensive physiotherapy; manipulation; muscle relaxants; and stress management techniques; exercise and stretching advice; and bowel cleansing programs.

differential diagnosis

• Ruptured intervertebral disk.
• Fracture.
• Muscle tear or strain/sprain.
• Infection of back or surrounding areas/nearby organs.
• Tumor.
• Congenital defects: sacralization of fifth lumbar vertebra, spina bifida etc.
• Spondylolisthesis.
• Stretching/laxity of the abdominal muscles (e.g. from obesity, pregnancy) causing back strain.
• Intrapelvic or retroperitoneal conditions.


footnotes