Back pain

Anatomy of the Vertebral Column
1. bones
  1. cervical vertebra
  2. thoracic vertebra
  3. lumbar vertebra
  4. sacral vertebra
  5. coccyx
2. joints
  1. Intervertebral Discs
    1. annulus fibrosus
    2. nucleus pulposus
  2. types
    1. Zygapophyseal Joints
    2. Atlanto Occipital Joint
    3. Atlanto Axial
3. Ligaments
4. muscles
  1. SUPERFICIAL LAYER
    1. Trapezius
    2. latissimus Dorsi
    3. Rhomboideus major
    4. Rhomboideus minor
    5. levator scapulae
  2. INTERMEDIATE LAYER
    1. serratus post. superior
    2. serratus post. inferior
  3. DEEP LAYER
    1. Splenius
      1. capitis
      2. cervicis
    2. Erector spinae
      1. spinalis
      2. longissimus
      3. Iliocostalis
    3. Transversospinalis
causes
1. Muscle or ligament strain
2. Bulging or ruptured disks
3. Arthritis
4. Skeletal irregularities
5. Osteoporosis
6. LUMBAR DISK DISEASE
7. DEGENERATIVE CONDITIONS
8. REFERRED PAIN FROM VISCERAL DISEASE
Risk factors
1. Age
2. Lack of exercise
3. Excess weight
4. Carrying too much weight
5. arthritis
6. cancer
7. Improper lifting
8. Psychological conditions
Investigation of back pain
1. HISTORY
  1. Onset of pain
  2. Location of pain
  3. Type and character of pain
  4. Aggravating and relieving factors
  5. Medical history
2. PHYSICAL EXAMINATION
  1. tenderness
  2. Pain with simulated testing
  3. Inconsistent responses with distraction
  4. Nonorganic regional disturbances
  5. Overreaction
3. LABORATORY TESTS
4. RADIOGRAPHIC EVALUATION
  1. MRI
  2. CT SCAN
  3. BONE SCINTIGRAPHY
5. Visual Analogue Scale
Psycho-social impact on complience
1. drug adherence
  1. ability and willingness to follow recommended health practices.
sciatica
1. pain caused by irritation of the sciatic nerve
2. Causes
  1. Lumbar Bulging Disc or Herniated Disc
  2. Lumbar Spinal Stenosis
  3. Spondylolisthesis
  4. Trauma
  5. Piriformis Syndrome
  6. Spinal Tumors
3. Sings and symptoms
  1. Shooting pain from the lower back, through the buttock, and down the back of either leg
  2. Numbness in the leg along the nerve
  3. Tingling sensation
4. Complications
  1. Loss of feeling in the affected leg
  2. Weakness in the affected leg
  3. Loss of bowel or bladder function
Physiotherapy
1. Herniated Disc Sciatica Management
2. Spinal Stenosis Sciatica Management
3. Piriformis Syndrome Sciatica Management
Alternative therapy
1. dietary supplements
2. megadose vitamins
3. herbal preparations
4. special teas
5. massage therapy
6. magnet therapy
7. spiritual healing
Surgical Intervention
1. Sciatic Nerve Decompression
2. Microdiscectomy & Discectomy
3. Laminectomy or Laminotomy
physical examination
1. general
  1. look
  2. feel
  3. move
2. special tests
  1. Straight leg raising
  2. abdominal exam
  3. femoral nerve stretch test
  4. schober's test
  5. the lower limb neurovascular status
  6. the upper limb neurovascular status

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Back pain

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	Created by mahmoud eladl over 7 years ago