Epidemiology And Management Of Spinal Pain Flashcards
Gender as a risk factor for lower back pain
Prevelance of back pain seems higher in women
What are the risk factors of lower back pain G A S B O P H
- gender
- age
- socioeconomic factors
- body weight
- heredity and heavy physical loading
- psychosocial factors
- occupational risk factors
Age as a risk factor in lower back pain
Overall prevalence increases with age until ages 69 or 65 years, and then gradually declines
Socioeconomic factors as a risk factor in lower back pain
Low educational status has been shown to be associated with an increased prevalence of low back pain
Body weight as a risk factor in lower back pain
Two studies found obesity or high body mass index to be associated with an increased occurrence of low back pain
Heredity and heavy physical loads has a risk factor for lower back pain
Heredity plays a major role in lumbar disk degeneration and that heavy physical loading, through occupation or sports is no longer considered as influential as previously thought
Psychosocial factors as a risk factor for lower back pain
- stress
- anxiety
- depression
- certain pain behaviours
- psychosocial factors are associated with transition from acute to chronic low back pain
- job dissatisfaction
- monotonous tasks
- poor work relationships
- lack of social support in the workplace
Occupational risk factors in the risk of lower back pain
There’s a clear correlation between physical demands of work and the prevalence of low back pain
80-90% of the population in low income earning countries are involved in heavy lifting which suggests a significant impact on the occurrence of low back pain
Risk factors for neck pain S L P P
- social factors
- lifestyle related factors (neck injuries, e.g. Whiplash)
- physical factors (fixed sedentary work postures are associated with an increased risk of neck pain, as well as poor work place design, hand and arm vibrations and twisting and bending of the trunk)
- psychosocial factors at work ( high job demands, poor social support, low job control, low skill discretion and low job satisfaction)
Risk factors for thoracic spinal pain in children F P B M S C D P A
- female gender
- postural changes associated with backpack
- backpack weight
- musculoskeletal symptoms
- specific sports
- chair height
- difficulty with homework
- poor mental health
- age transition
In adults thoracic spinal pain was associated with?
concurrent musculoskeletal symptoms and difficulty in performing activities of daily living
What not to do!
OVEREMPHASIS ON STRUCTURAL DIAGNOSIS
- don’t over emphasise structural diagnosis
- do a focussed history and physical examination to rule out any underlying conditions
- such an approach facilitates classification of patients into 3 categories
- non-specific low back pain
- pain associated with radiculopathy or spinal stenosis
- back pain associated with another specific spinal cause
What not to do!
OVER PRESCRIPTION OF BED REST
- make sure they remain active
- if they need bed rest to relieve severe symptoms, ensure they return to normal activity u as soon as possible
What not to do!
OVERUSE OF SURGERY
Although surgery may provide rapid relief of symptoms, it dos have more serious morbidity and rarely mortality and of course it may not be successful
What not to do!
OVER EMPHASIS ON PSYCHOGENIC DIAGNOSIS
- telling patients that there is nothing wrong And their pain doesn’t exist
2 types
Pain avoidance behaviour which presents as anxiety
Phycological distress- treatment dependency
