Back Pain

Back Pain is a topic covered in the 5-Minute Emergency Consult.

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Basics

Description

  • Low back pain (LBP):
    • Refers to pain in the area between the lower rib cage and the gluteal folds, often with radiation into the thighs
  • Sciatica:
    • Pain in the distribution of the lower lumbar spinal roots
    • May be accompanied by neurosensory and motor deficits
  • Pain classification:
    • Acute: <6 wk
    • Subacute: 6–12 wk
    • Chronic: >12 wk

Etiology

  • Nonspecific musculoligamentous source (great majority) (e.g., muscle, ligament, fascia)
  • Herniation of the nucleus pulposus
  • Degenerative joints or discs
  • Spinal stenosis
  • Anatomic abnormalities—especially spondylolisthesis
  • Fractures from trauma and osteoporosis
  • Underlying systemic diseases (minority):
    • Neoplasm
    • Infections
    • Vascular (dissection, aneurysm, and thrombosis)
    • Renal
    • GI
    • Pelvic organ pathology

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