Low back pain

Definition. The term encompasses many types of pain in the lower back, namely, pain at the sacrum, coccyx and the lumbar spine, back pain and sciatica, low back pain is more common in women than in men.

Causes

A. gynecological causes. These are less important causes of low back pain. The causes can be as follows:

(1) with uterine retroversion may cause the pelvic ligaments to pull back, this will be relieved when lying down.

(2) tubo ovarian cancerMass, salpingitis and chronic cervicitis;

(3) benign and malignant tumors of the pelvis affects uterine or ovarian cyst, pelvic endametriosis, advanced carcinoma of the cervix, retroperitoneal tumor;

(4) because of postoperative sacro iliac strain following gynecological surgery in the lithotomy position under general anesthesia;

(5) Premenstrual low - especially in pain, premenstrual syndrome.

Site about back pain due to gynecologic cause is extended but never sacral above the fourth lumbar vertebra, it has bilateral distribution, but has not been localized. Above-mentioned causes back pain is not necessarily in all cases.

1. Orthopedic causes. These are the most common cause. There are numerous factors that can play. Some important are the following --

(i) Sacro iliac strain or subluxation is often followed by pregnancy and childbirth. The pain is felt on the lifting weight or move ¬ ment to stoop. It is tenderness at the ISG> Joint;

(ii) postural muscles and ligaments causing strain on the back is possible, because the posture error. Obesity can also lead to so charged;

(iii) arthritis of the spine;

(iv) congenital anomalies of the last lumbar sacralization or lumbarisation the first sacral vertebra, spina bifida occulta can back pain;

(v) lumbago is due to myositis of the lumbar spine;

(vi) Coccydynia Coccyx pain often following work. Tenderness can betriggered on movement of the coccyx;

(vii) other diseases of the spine of the intervertebral disc prolapse, caries spine, compression of the spinal cord.
Sites of pain in orthopedics each lead after each lesion, but tend to be localized pain with tenderness in one place, the pain is also associated with the exercise or rest. Sacroiliac strain is worse at night, while flat on his back or on Turn the page.

II Nonorthopaedic causes.

(1) distribution of pain, kidney painFeature means the join in the one-sided here.

(2) Rectal pain. Constipation, cramps, or rectal cancer have sacral pain or discomfort.
In some cases, no detectable cause can be found for back pain. psychological disturbance is accused of being a factor to play in this group.

Investigations.

1. A careful history, thorough clinical examination of the patient's general condition, pelvis condition, should be done. Examination of the spine and back, especially for all localTenderness is essential. Radiology of lurnbosacral region is al ¬ ways taken to identify clearly a lesion. Urological examinations are taken in the cases suggested benefit the cause.

2. Cases show no gynecological factor for back pain should be transferred to the orthopedic surgeons.

Treatment. This is done for the cause. The gynecologic causes are treated. For the orthopedic causes, local application of heat, by some local massage ointment, rest, analgesics cantaken before taking the orthopedist, the cause of the treatment.