DOI: 4/16/2012. Patient is a 29-year-old male technician who sustained injury when he was 25-feet up on a ladder when the ladder slid and he fell onto the pavement. He had an open reduction internal fixation (ORIF x 2) for a compound tibia fibula fracture and had hardware removal in 4/25/2013. MRI of the lumbar spine performed on 3/24/2016 revealed L5-S1 small right paracentral disc protrusion without significant spinal canal stenosis or neuroforaminal narrowing. Per procedure reports, the patient is status post therapeutic bilateral sacroiliac intra-articular injection on 02/18/16, diagnostic bilateral sacroiliac intra-articular injection on 02/05/16, confirmatory bilateral L3-5 medial branch nerve block on 01/25/16, diagnostic bilateral L3-5 medial branch nerve block on 01/11/16, bilateral L5-S1 transforaminal epidural injection on 04/06/15, bilateral L5 dorsal ramus …show more content…
Patient denies any complications and new complaints associated with epidural steroid injection procedure; however, he states that approximately 5 days after the injection procedure, he felt a sharp shooting pain down the posterior aspect of both legs to the feet to the feet when lying on his back with his feet on the floor. Otherwise, he reports ongoing axial lower back pain and weakness with no significant radicular symptoms at this time. He reports only mild relief with use of over-the-counter ibuprofen. In addition, he reports of moderate pain located at the low back which describes as an aching, continuous and sharp pain. He rated his pain as 5/10 in severity at the time of visit. Pain radiates from the lower back and aggravated by bending, getting in and out of the car, lifting, reciprocating stairs, sitting, standing, turning, twisting and walking which is mildly alleviated by over-the-counter drugs and
DOI: 7/28/2014. Patient is a 33-year old male laborer who sustained injury when his left wrist twisted and snapped while using a drill. Per OMNI, he was initially diagnosed with dislocation of the left wrist. He underwent a tendon graft reconstruction on 08/07/14 and hardware removal on 09/11/14.
On examination of the back, there is tenderness upon palpation midline of the lower lumbar and sacral region. Posture shift is to the left.
DOI: 5/22/2000. Patient is a 52-year-old female stitcher operator who sustained injury while she was pushing load onto a stitcher when she strained her right shoulder, wrist elbow, and neck. She underwent exploration of cervical fusion at C5-T7 with anterior cervical discectomy with fusion at C3-C5 on 12/13/11 and implantation of new implantable pulse generator (IPG) and spinal cord stimulator unit on 09/17/14. Based on the latest medical report dated 01/29/16, the IW presents for follow up of neck and shoulder pain.
One of the disorders associated with it is a cervical radicular syndrome. To treat such medical problems, the physicians are recommending and performing surgeries on patients is one of the main techniques used (Arts et al., 2010). However, surgery has some outcomes that could be serious and the physicians and patients should discuss all of them before a choice is made. Some of these outcomes include chances of a Neck Disability Index, pain in the neck as well as the arm, complications, costs after charges, perceived recovery, and anxiety. Some of the surgical techniques that could be used include anterior discectomy with interbody fusion, anterior discectomy with disc prosthesis and anterior discectomy only (Arts et al., 2010).
DOI: 8/15/2016. Patient is a 65-year-old male manager who sustained injury while he was lifting a tire that was lying flat on the ground when he slipped and felt a pull in his back. Per the procedure report dated 10/14/16, the patient had a lumbar trigger point injection. Based on the medical report dated 11/16/16, the patient complains of lower back pain which is sharp, dull and achy in nature. The lower back pain radiates to bilateral side, bilateral hips and bilateral legs.
At first, patients may have severe pain which can be described as a deep dull ache similar to sharp stabbing pain. Some people also experience tingling, numbness, muscle weakness in knee, hip or ankle movements. The shin or sciatica is typically worsened by sneezing, coughing, bending or prolonged sitting. Causes: Degeneration of the disc or disc aging is a gradual process. A lumbar disc prolapse occurs when the annulus is too weak for preventing the nucleus prolapsing out.
The paper below evaluates spinal manipulative therapy and the extent to which it is a useful treatment strategy for chronic lower back pain. It is proposed that spinal manipulative therapy offers therapeutically acceptable short-term relief for patients in the treatment of chronic lower back pain due to its non-invasive nature. Thorough reviews of several studies were the means by which this hypothesis was tested. EBSCO host and PubMed searches were used for this paper.
Spinal disc herniation is a type of intervertebral disc protrusion, in which the intervertebral disc nucleus moves towards the anulus (the fibrous ring surrounding the disc) and slips out of its place, following which the nerve is subject to pressure. (Smeltzer et al., 2010). This condition is caused by sudden or gradual collapse of ligaments and supporting tissues around the intervertebral disc (Fatemi, 2011). Spinal disc herniation is among the most common degenerative disorders in vertebral column (Yang et al., 2015), which can eventually lead to lower back pain and radicular pain (Yang et al., 2015). In other words, the intervertebral disc herniation is currently the most frequent cause of lower back pain throughout the world (Saleem et
Pain is aggravated by lifting and movement, and relieved by rest. Associated symptoms are decreased mobility, and joint instability and
It is also important to screen for red flags to exclude possible specific conditions. These include back pain with radiation below the knee level or sensory motor dysfunction. These patients should not be treated and should be referred to a specialist for
1. Introduction: Chronic nonspecific low back pain (CNSLBP) (i.e., low back pain of at least 12 weeks’ duration and without a specific cause)(1, 2) is one of the most common health conditions worldwide(3). Chronic low back pain (CLBP) is highly associated with disability (1), emotional changes (2), and work absenteeism (1). Given that chronic low back pain is very prevalent (4), the costs associated with this condition are very high (5).
Low back pain is neither a disease nor a diagnostic entity of any sort. The term refers to pain of variable duration in an area of the anatomy afflicted so often that it is has become a paradigm of responses to external and internal stimuli (Ehrlich GE 2003). Research study on low back pain has shown that it is a common problem in general population. As seen in Western industrialized countries, back pain is one of the major health problems (R Ayiesah and D Ismail 2007).
1 INTRODUCTION Chronic low back pain is the pain in the lower back area for longer than 3 months created by injury, disease or stress. It may include the pain in bone, nerve and muscle. The quality of pain may be aching, burning, stabbing, or tingling, sharp or dull and well defined or vague (Akuthota, Baker, & Danisa, 2009). It is a most common problem all over the world and the age group 40 to 80 years (D. G. Hoy et al., 2012).
One form of conservative therapy which has gained increased attention from clinicians and researchers in the management of back pain among general population is that advocated by McKenzie (1980 and 1981) [15, 16]. Studies from different parts of the world had offer strong support for the acceptance of the McKenzie protocol (MP) in treating back pain in the general population [17, 18, 19]. (Battie et al., 1994; Foster et al, 1999, Ayanniyi et al, 2006) Such investigations, however, have left unclear the specific effect of MP on back pain in pregnancy.
Low back pain is one of the most common complaint seen in the hospital. The purpose of this review is to identify the recent advances in the management of low back pain. This review shows diagnostic studies, pharmacological, interventional, surgical, and non-pharmacological management of low back pain. Many patients with low back pain receive routine imaging for the spins which include lumber radiology, computed tomography (CT), and magnetic resonance imaging (MRI). According to the American College of Physicians(ACP), and American Pain Society (APS) recommendations, the routine imaging dose not result in any clinical improvement or benefits.