Back pain is one of the commonest causes of clinic visits and hospitalizations in Blue Bell, PA. The incidence is highest in the sixth and seventh decades of life with a slightly higher proportion of women being affected. The underlying causes are widely varied. They include, among others, trauma, infections, tumors as well as degenerative changes within spinal components. The pattern of symptoms in chronic back pain is likely to vary slightly depending on the part of the back that is affected and the cause.
Pain originates from the various structures that make up the spinal column. These include the bony structures (mainly the vertebra), ligaments, muscles, nerves and inter-vertebral discs. There is an increase in incidence with advancing age due to degenerative changes that affect these components. Osteoarthritis, an inflammatory condition that affects many large joints, is one of the major conditions encountered under this category.
The tumors that affect the spine may either originate from the spine itself or may be metastasis originating from other organs. Multiple myeloma is the commonest primary tumor known to cause back discomfort. Most of the other cases are due to metastasis. The tumors that are likely to have metastatic to the spine include breast, thyroid, renal and prostate cancers. Metastasis should be suspected in persons that have any of these (or any other tumors) with back discomfort.
Symptoms resulting from slippage of an inter-vertebral disc usually have a sudden onset. If unattended, it remains constant or may be experienced from time to time. In a majority of the cases, the symptoms follow a heavy lifting event or a blunt force to the back. Typically, the symptoms tend to be experienced on one side of the body and are worsened with activity. The level of slippage determines whether the lower or the upper limbs will be affected.
To establish what the cause of the problem is, one has to give a comprehensive medical history and undergo a systemic physical exam. At the same time, several investigations have to be done as guided by the pattern of symptoms and the findings of the physical examination. Radiological images such as the X-ray, the CT scan and radionuclide studies are vital to the diagnostic process and are almost always a requirement.
There are a number of treatment options that exist. These are classified into pharmaceutical agents, physical therapies and surgical intervention. Analgesic drugs are chosen depending on the severity of symptoms. In cases of mild symptoms, aspirin, acetaminophen, ibuprofen and other non-steroidal anti-inflammatory drugs are typically used. Stronger drugs such as steroids and opioids are reserved for the severe cases.
Physical therapies are most effective for conditions that affect joints and muscles. Examples of commonly used therapies include massage, heat and cold treatments, physical exercises and electrical stimulation among others. One of the mechanisms involved in these treatments is strengthening of muscles. Patients usually exhibit different responses depending on the nature of their illness.
Surgical intervention should only be considered if the conservative methods have failed. Spine surgeries are broadly classified into decompression operations and spinal fusion. Surgery tends to be successful in cases where symptoms are caused by a prolapsed disc or fractured vertebral body.
Pain originates from the various structures that make up the spinal column. These include the bony structures (mainly the vertebra), ligaments, muscles, nerves and inter-vertebral discs. There is an increase in incidence with advancing age due to degenerative changes that affect these components. Osteoarthritis, an inflammatory condition that affects many large joints, is one of the major conditions encountered under this category.
The tumors that affect the spine may either originate from the spine itself or may be metastasis originating from other organs. Multiple myeloma is the commonest primary tumor known to cause back discomfort. Most of the other cases are due to metastasis. The tumors that are likely to have metastatic to the spine include breast, thyroid, renal and prostate cancers. Metastasis should be suspected in persons that have any of these (or any other tumors) with back discomfort.
Symptoms resulting from slippage of an inter-vertebral disc usually have a sudden onset. If unattended, it remains constant or may be experienced from time to time. In a majority of the cases, the symptoms follow a heavy lifting event or a blunt force to the back. Typically, the symptoms tend to be experienced on one side of the body and are worsened with activity. The level of slippage determines whether the lower or the upper limbs will be affected.
To establish what the cause of the problem is, one has to give a comprehensive medical history and undergo a systemic physical exam. At the same time, several investigations have to be done as guided by the pattern of symptoms and the findings of the physical examination. Radiological images such as the X-ray, the CT scan and radionuclide studies are vital to the diagnostic process and are almost always a requirement.
There are a number of treatment options that exist. These are classified into pharmaceutical agents, physical therapies and surgical intervention. Analgesic drugs are chosen depending on the severity of symptoms. In cases of mild symptoms, aspirin, acetaminophen, ibuprofen and other non-steroidal anti-inflammatory drugs are typically used. Stronger drugs such as steroids and opioids are reserved for the severe cases.
Physical therapies are most effective for conditions that affect joints and muscles. Examples of commonly used therapies include massage, heat and cold treatments, physical exercises and electrical stimulation among others. One of the mechanisms involved in these treatments is strengthening of muscles. Patients usually exhibit different responses depending on the nature of their illness.
Surgical intervention should only be considered if the conservative methods have failed. Spine surgeries are broadly classified into decompression operations and spinal fusion. Surgery tends to be successful in cases where symptoms are caused by a prolapsed disc or fractured vertebral body.
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