BACK PAIN. Presentation by Dr Cyril Evbuomwan PPG

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1 BACK PAIN Presentation by Dr Cyril Evbuomwan PPG

2 What is back Pain It is a common problem which affects 4 out 5 people at some point. Often caused by simple strain in muscle, tendon or ligaments It can be acute(sudden onset) or chronic lasting weeks and often on and off. Structure Back is designed to give strength and flexibility to the body. It is made of 33 bones stacked on each other with disc as cushion, supported by lots of strong ligament and muscles On each side of the bone are small joints called facet joints The bones, disc and ligaments all age as we grow older

6 Causes of back pain Commonest cause is simple strain in the muscle, tendon and ligamentsimple back pain. This may result from bad posture, lack of exercise Spondylosis: This is the type of back pain which results from wearing of the bone, disc and facet joints. The spaces between the bones become narrow. Sciatica: The back pain travels to the leg because of the irritation or compression of the nerves in the back Spinal Stenosis: This is the type of back pain which starts when you wake up in the morning. It settles quickly as you sit down Other rare causes of pain are Tumour Infection like Tb Inflammation Trauma resulting infracture

7 Back Pain: When should I see the Doctor The commonest cause of back pain is simple strain. You don t need to see the doctor except It is lasting for a long time Affecting everyday activities

8 Back Pain: When should I see the Doctor Very rarely back pain can be a sign of a serious problem. So see the doctor if you If you have problem controlling or passing urine If you cannot feel(numbness) around the anus or genitals Lose control of your bowel Have weakness of your legs or unsteady on your feet Have pain which has become very severe over the weeks These are what we call RED FLAG Signs

9 Back pain: How can I help myself Pain Killers Paracetamol 2 4 times a day(max 8 tablets) Ibuprofen 400mg 3 times a day-can upset stomach Use when necessary, regularly and at the right dose Can use up to 7-10 days. If no relief then unlikely to help Can also use gel to rub into the area

10 Back pain: How can I help myself Exercise: The most important way to help the back pain. It enables the body to heal itself-endophins Start slowly and build up the exercise It may feel sore initially after exercise but it will improve It is important to continue the exercise even when the pain stops. It helps to strengthen your back and improves fitness Exercise includes Walking Swimming Yoga and pilates Gym

12 Back Pain: Diagnosis As most back pain is simple, no test is necessary. A check by the doctor is enough. The doctor will request test if Injury is suspected There is a possible cause MRI or CT scan is the best test X-ray for back pain is not useful because most causes of soft tissue Most changes on x-ray may not be the cause of the pain as they occur with age

13 Back Pain: Available treatments Physical Therapies Physiotherapy Occupational Therapy Drugs Paracetamol/ ibuprofen Amitriptyline-relaxes muscle Gabapentin/Pregabalin Steroid injection Surgery only for 2% of patients need surgery

14 Back Pain: Outcome 75-90% of patients with back pain will recover within few weeks. For those with pain for a long time, the pain is likely to be present-chronic. Going back to work help with back pain recovery If you respond emotionally to back pain, recovery will be slow. Sometimes anti-depressant helps with chronic pain

15 Back pain: Summary Back pain is common but most cases aren't caused by a serious problem. Most cases of back pain get better on their own within a few weeks. Stay active. Bed rest for more than a couple of days makes it harder to get going. Gradually increase your normal activities and do regular exercise. Take painkillers if needed so you can stay active. Your pain should ease within 2 weeks and you should recover over approximately a 4-6 week period. You should carry on with the exercises for at least 6-8 weeks to help prevent another injury. If the pain is severe or not improving after a week or so, contact your doctor Reference Arthritis Research UK

Acute Lower Back Pain. Physiotherapy department

Acute Lower Back Pain. Physiotherapy department Acute Lower Back Pain Physiotherapy department Back pain is a common condition and in the UK it affects 7 out of 10 people at some point in their lives. Back pain can be very uncomfortable but it is not