LOW BACK PAIN

Low Back pain is a musculoskeletal problem encountered by most of the adults at some time in their life. It’s a most common medical problem. There can be variety of causes of low back pain ranging from minor ligamentous sprain to spinal tumour or fracture.
Etiology of low back pain can be categorized as follows-
1. Mechanical Low Backache
• Ligamentous Sprain
• Muscle Strain
2. Degenerative
• Lumbar Spondylosis
• Disc prolapse / slip disc
• Spondylolisthesis
• Spinal stenosis
3. Inflammatory
• Ankylosing spondylitis
• Rheumatoid arthritis
• Osteomyelitis
4. Neoplastic
• Tumors
5. Metabolic
• Osteoporosis
• Osteomalacia
The diagnosis of Low back pain is based on medical history, physical examination including range of motion of back and hip, tests of neurological involvement, muscle strength testing and diagnostic tests like X ray and MRI.
The treatment options depend on the nature of the pain, whether acute or chronic and cause of the pain and accordingly may vary from conservative to surgical. Our focus here is on conservative treatment which includes-
• Analgesics and anti-inflammatory drugs/NSAIDS
• Muscle relaxants
• Various electrotherapeutic modalities like SWD (short wave diathermy), MWD (microwave diathermy), Ultrasound, IFT (interferential therapy), TENS (transcutaneous electrical nerve stimulation).
• Moist heat- Hot packs.
• Lumbar corsets.
• Spinal manipulation
• Exercises to strengthen stretch and condition the back muscles- It is generally recommended in chronic cases. Usually exercise is not performed in acute cases of low back pain. Commonly performed exercises include-
Spinal extension exercises, pelvic tilts, abdominal curls, back rotation exercises.