BACK PAIN Presentation by Dr Cyril Evbuomwan PPG 12.9.2018 What is - - PowerPoint PPT Presentation

BACK PAIN

Presentation by Dr Cyril Evbuomwan PPG 12.9.2018

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
• ften 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

Causes of back pain

• Commonest cause is simple strain in the muscle, tendon and ligament-

simple 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

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

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

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

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

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

• ccur with age

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

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

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