Orthoteers homepage Advertise on Orthoteers
Orthoteers Junior Orthoteers Orthopaedic Biomechanics Orthopaedic World Literature Society Educational Resources Image Gallery About Orthoteers Orthoteers Members search

Back Pain

Prevalence

  • 60-80% of people will have LBP sometime in their lives.
  • 30% are referred to Ortho; 3% admitted; 0.5% operated.
  • 90% LBP resolves in 6w, 75% may experience symptoms & disability one year after initial consultation.
  • The prevalence of LBP has changed little over the years, but the associated disability has increased four fold since the 1970s. 
  • In the UK certified incapacity for LBP was 120 milion days in 1996/7. 
  • Overall cost of LBP in 1993 was £6 billion. 14 million consultations in 1993.

Differential Diagnosis according to Age:

  • Children
    1. congenital disorders
    2. developmental disorders
    3. infection
    4. primary tumours - eosinophilic granuloma, ewing's sarcoma, metastatic neuroblastoma, spinal cord tumours
  • Young Adults
    1. disc disease
    2. spondylolisthesis
    3. fractures
    4. Scheuermann's disease
    5. Ankylosing spondylitis
  • Older Adults
    1. spinal stenosis
    2. metastatic disease
    3. osteopaenic fractures
    4. infection

Types of Back Pain:

  1. Discogenic back pain
    • pain from the innervated ligamentous layer of the annulous fibrosis when it is stretched with a bulging disc
    • it is midline & worse with lordotic postures, bending & lifting
  2. Radicular back pain
    • pain extending to the buttock and/or leg
    • associated with disc herniation or spinal stenosis or intraspinal pathology
  3. Referred back pain
    • Aortic Aneurysm
    • Visceral (ulcer, PID, endometriosis, gallbladder disease, pleural disease)
    • Infection
    • UTI, PID
    • Hip Arthritis
  4. Iatrogenic back pain
    • dural adhesions 
    • post surgical instability
    • post operative discitis; arachnoiditis
  5. Psychogenic back pain
    • must exclude organic pathology
    • Waddell's inappropriate signs often present


This is a preview of the site content. To view the full text for this site, you need to log in.
If you are having problems logging in, please refer to the login help page.


© 2005-2007 Orthoteers.co.uk - last updated by Len Funk on 11 February 2005Medical Merketing and SEO by Blue Medical 
Biomet supporting orthoteersThe British Orthopedic Association supporting OrthoteersOrthoteers is a non-profit educational resource. Click here for more details
Anatomy & Biomechanics
Ankylosing Spondylitis
Back Pain
Cervical Spine Disc Disease & Cervi...
Cervical Spine Trauma
Disc Disease
Infections (+ TB)
Literature search on Waddell G
Other Cervical Spine Disorders
Rheumatoid Spondylitis
Sacrum & Coccyx
Scoliosis
Spinal Injuries - Principles
Spinal Stenosis
Spine Embryology
Spondylolysis & Spondylolisthesis
Waddells Nonorganic Signs
Hide Menu