Tina Williams "Low Back Pain" iHuman
what is referred LBP? - Felt in the lower back but source of pain is in another location
ex: kidney
... [Show More] stones
Why is lower back pain a common problem? - - bears most body weight
- most flexible part of spine
- contains nerve foots that are at risk for injury
- naturally poor biomechanical structure
What determines ACUTE back pain? - - lasts 4 weeks or less
- caused by trauma or stress (hyper flexion, heavy lifting, sports injury)
- symptoms usually appear in 24 hours, not at the time of injury, d/t pressure build up
Why won't MRI/CT work to diagnose LBP? - - MRI findings are limited when increased edema is around injury
- they will only work with trauma; won't pick up soft tissue soreness
What is a disc herniation? - the spongey part between discs ruptures/opens
Why should we advise against sleeping in a prone position for patients who have LBP? - it produces excessive lumbar lordosis, placing excessive stress on the lower back
Encourage patient to sleep in a supine or side-lying position with the knees and hips flexed to prevent unnecessary pressure on support muscles, ligaments, and lumbosacral joints.
What is lower back pain most often due to? - musculoskeletal problem
What is localized lower back pain? - patients will feel soreness when a specific area of lower back is palpated/pressed
What is diffuse LBP? - occurs over a larger area and comes from deep tissue
What is radicular pain? - caused by irritation of a nerve root. Not typically isolated to single location. radiates along nerve root
ex: sciatica
If patient MUST sleep on back - Sleep on back with a lift under knees and legs or back with 10-inch-high pillow under knees to flex hips and knees
What type of mattress is recommended for LBP? - a firm mattress
Why is smoking cessation important for patients who have LBP? - Tobacco use impairs circulation to the intervertebral discs and may contribute to low back pain.
Do you want to advise patients with LBP to prevent increased pain by placing a foot on a step or stool during prolonged standing? - yes
Exercise __ minutes in the morning and evening regularly - 15
What determines CHRONIC low back pain? - - longer than 3 months, involves repeated incapacitating episodes
- often progressive, cause can be hard to determine
What are some causes of chronic LBP? - - degenerative conditions like arthritis
- osteoporosis
- metabolic bone diseases
- weakness from scar tissue of prior injury
- chronic strain on lower back from obesity, pregnancy, stressful job postures - congenital spine problems
What is spinal stenosis? - narrowing of the spinal canal, commonly caused by osteoarthritis
Manifestations of spinal stenosis? - - lower back pain that radiates to butt and leg
- increased pain with walking, prolonged standing
- numbness, tingling, weakness, heaviness in legs and butt
- pain lessens when bending forward or sitting down
What is a typical sign of spinal stenosis? - Decreased pain when the patient bends forward or sits down
Pharmacologic measures for LBP - - Manage the patient's pain and stiffness with mild analgesics, such as NSAIDs, is integral to the daily comfort of the individual with chronic low back pain.
- Antidepressants (e.g., duloxetine [Cymbalta]) may help with pain management and sleep problems.
- The antiseizure drug gabapentin (Neurontin) may improve walking and relieve leg symptoms.
Treatment for LBP - - Weight reduction
- Sufficient rest periods [Show Less]