Back Pain - Sciatica

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Back Pain - Sciatica

NIH - Medical Encyclopedia Back pain - low

"The specific structure in your back responsible for your pain is hardly ever identified. Whether identified or not, there are several possible sources of low back pain: • Small fractures to the spine from osteoporosis • Muscle spasm (very tense muscles that remain contracted) • Ruptured or herniated disk • Degeneration of the disks • Poor alignment of the vertebrae • Spinal stenosis (narrowing of the spinal canal) • Strain or tears to the muscles or ligaments supporting the back • Spine curvatures (like scoliosis or kyphosis) which may be inherited and seen in children or teens • Other medical conditions like fibromyalgia. "

Highlighted Article

Treatment of acute sciatica. (Am Fam Physician. 2007)

"Acute sciatica is lower back pain with radiculopathy below the knee and symptoms lasting up to six weeks. … caused by a variety of conditions: disk herniation, lumbar spinal stenosis, facet joint osteoarthritis or other arthropathies, spinal cord infection or tumor, or spondylolisthesis. … Clinical Commentary: An efficient clinical history and thorough physical examination of a patient with suspected sciatica is needed to rule out urgent conditions like cauda equina syndrome, infection, or cancer, and to determine the need for diagnostic tests. After the acute episode, emphasis is placed on activity, back exercises, behavioral techniques, ergonomics education, and close clinical monitoring. Educating patients on self-care and establishing reasonable expectations usually increase patient compliance with therapy and improve satisfaction."

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Back Pain and Sciatica

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A new episode of low back pain: Who relies on bed rest? (Eur J Pain. 2007) "Based on these results we conclude that prolonged bed rest in the early phase of pain is associated with a higher long term disability level. In preventing low back disability, GP screening for catastrophizing and fear of injury in LBP patients who had prolonged bed rest merits consideration."

Association of Back Pain Frequency With Mortality, Coronary Heart Events, Mobility, and Quality of Life in Elderly Women. (Spine. 2007) "CONCLUSION.: Daily back pain is associated with reduced quality of life, mobility and longevity and increased risk of coronary heart events. The adverse health effects of chronic back pain deserve greater recognition."

Back Pain in the German Adult Population: Prevalence, Severity, and Sociodemographic Correlates in a Multiregional Survey. (Spine. 2007) "RESULTS: Point-prevalence was 37.1%, 1-year prevalence 76.0%, and lifetime prevalence 85.5%. A substantial minority had severe (Grade II, 8.0%) or disabling back pain (Grade III-IV, 11.2%). Subjects with a low educational level reported substantially more disabling back pain. This variable was an important predictor for large cross-regional differences in the burden of back pain. CONCLUSION: Back pain is a highly prevalent condition in Germany. Disabling back pain in this country may be regarded as part of a social disadvantage syndrome."

Comorbidity of low back pain: Representative outcomes of a national health study in the Federal Republic of Germany (European Journal of Pain 2007) "One in three Germans (34%) experienced back pain during the seven days prior to being interviewed. The one-year prevalence rate is 59%. All the morbidities investigated by us are more common in subjects with back pain than in individuals without back pain. The most common comorbidities associated with back pain are musculoskeletal disorders like rheumatoid arthritis, osteoarthritis and osteoporosis, followed by cardiovascular and cerebrovascular disease. … In view of the large percentage of unspecific back pain, we believe it is important for physicians treating back pain to extend their history and diagnostic analysis skills to embrace comorbidities related to the back pain."

Disc degeneration in low back pain: a 17-year follow-up study using magnetic resonance imaging. (Spine. 2007)

Effect of a simple information booklet on pain persistence after an acute episode of low back pain: a non-randomized trial in a primary care setting. (PLoS ONE. 2007)

Factors associated with back pain after physical injury: a survey of consecutive major trauma patients. (Spine. 2007) "CONCLUSIONS: This study highlights the importance of psychosocial factors as predictors of symptomatic back pain after major physical trauma. The findings do not support physical factors as important contributors to future low back pain."

Frequency of low back pain among men and women aged 30 to 64 years in France. Results of two national surveys. (Ann Readapt Med Phys. 2007) "RESULTS: More than half of the French population in this age group experienced LBP at least one day in the previous 12 months (LBP1), with 17% experiencing LBP for more than 30 days in the previous 12 months (LBP30); prevalence differed between men and women and that of LBP30 increased with age. DISCUSSION-CONCLUSION: The prevalence of LBP as assessed by the National Health Survey is similar to that found in countries other than France."

Hypovitaminosis D in female patients with chronic low back pain. (Clin Rheumatol. 2007) "Despite the sunny climate, hypovitaminosis D is prevalent among Egyptian women in the childbearing period, especially those presenting with chronic LBP, where it is associated with hyperphosphatasia and hyperparathyroidism, without alterations in serum calcium. The major determinant of hypovitaminosis D in our patients is limited sun exposure."

Is there a relationship between parity, pregnancy, back pain and incontinence? (Int Urogynecol J Pelvic Floor Dysfunct. 2007) "This study suggests that pregnancy may lead to earlier development of back pain, without affecting long-term prevalence. Incontinence and back pain may be related because of contribution of the trunk muscles to continence and lumbopelvic control."

Mental disorders among persons with chronic back or neck pain: Results from the world mental health surveys (Pain 2007) "Although prevalence rates of back/neck pain were generally lower than in previous reports, mental disorders were associated with chronic back/neck pain. The strength of association was stronger for mood and anxiety disorders than for alcohol abuse/dependence. The association of mental disorders with back/neck pain showed a consistent pattern across both developed and developing countries."

Patient Expectations as Predictors of Outcome In Patients with Acute Low Back Pain. (J Gen Intern Med. 2007) “CONCLUSIONS: In patients with acute LBP, higher expectations for recovery are associated with greater functional improvement. Eliciting patient expectations for improvement may be a simple way to identify patients with the highest (or lowest) likelihood of experiencing functional improvement. Incorporating questions about patient expectations in future trials may clarify the role of this important correlate of clinical outcomes.”

Prevalence of low back pain in greek public office workers. (Pain Physician. 2007)

Relationship between spinal stiffness and outcome in patients with chronic low back pain. (Man Ther. 2007 )

Sciatica: a review of history, epidemiology, pathogenesis, and the role of epidural steroid injection in management. (Br J Anaesth. 2007) "Radicular pain in the distribution of the sciatic nerve, resulting from herniation of one or more lumbar intervertebral discs, is a frequent and often debilitating event. The lifetime incidence of this condition is estimated to be between 13% and 40%. Fortunately, the majority of cases resolve spontaneously with simple analgesia and physiotherapy. However, the condition has the potential to become chronic and intractable, with major socio-economic implications. This review discusses the history, epidemiology, pathophysiology, and natural history of sciatica."

Short-term Prospective Memory Deficits in Chronic Back Pain Patients (Psychosomatic Medicine 2007) "Results: In comparison to those not in pain, participants with chronic pain had significantly impaired short-term prospective memory, an effect which was evident even after co-varying use of analgesics and other drugs."

Urinary incontinence in women with low back pain. (Man Ther. 2007)

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Back Pain - Sciatica

Back Pain - Sciatica

Back Pain and Sciatica

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