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Lower Back Pain (LBP)

Last updated 13.02.13

 

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Index

 

Causes

-  Mechanical

-  Arthritidies

-  Inflammatory: RA, Ankylosing Spondylitis, IBD, Reactive arthritis, Psoriatic arthritis, Juvenile spondyloarthritis

-  Non-Inflammatory: OA

-  Infective: Osteomyelitis

-  Neoplastic: Multiple Myeloma, Ca

-  Visceral Referral: Pancreatitis, PUD

-  Vascular: AAA, Aortic Dissection

 

Red Flags

-  Night, bone pain: Ca

-  New onset severe pain: Aortic Dissection, ruptured AAA, Cord compression

-  Haemodyanimc instability: Aortic Dissection, ruptured AAA

-  Neurological defecit: saddle anaesthesia, incontinence: cord compression

-  Weight loss: Ca

 

Inflamatory Back Pain (Spondyloarthritis)

-  Morning stiffness >30min

-  Improvement with exercise but not rest

-  Awakening with back pain during second half of night

-  Alternating buttock pain

 

Ix

-  Schober test

-  Plain film X-ray

-  Inflammatory pain: HLA-B27, ESR, CRP