Back pain has multiple causes
1. Simple causes of back pain – Lumbar spine
spondylogenic / Metabolic / Mechanical/ Muscular / Postural / visceral / Reffered.
Often related to life style , posture , lack of exercise , Vit deficiency , increasing weight and stress. Do not have associated nerve compression
RED FLAG signs absent usually
Investigations often not needed unless pain persists >3 weeks
Pain is typically localised , fatigue related , better with rest , and exercises help a lot , need life style modification. Pain management with simple measures – exercise , medicines and heat therapy , supervised physiotherapy help. Meet spine specialist for supervised care.
Usually improve without any active / aggressive intervention
Contact specialist if pain persists or progresses.
2. Disease related back pain
- Tuberculosis / Infection / Trauma / Instability / Tumor / inflammation / Nerve compression related causes.
- Symptoms often more with activity / affect mobility / increase with walking
- Symptoms often present at rest / night pain
- Radiation to leg with nerve paresthesiae present if nerve compression is present.
- Pain , Numbness , Heaviness weakness in leg – buttock and back of thigh and calf
- RED flag signs noted.
- Fever , Rest pain , Night pain , persistent pain , weakness leg , bowel bladder symptoms
May need investigations to detail to rule out exact cause , unsupervised pain management – self medication / self guided physiotherapy – not recommended and may not help.
