Mechanical Lower Back Pain
Facet Joint syndrome
Epidemiology
What are possible RED FLAGS?
Pathophysiology
Definition: lower back pain is described as pain that is consistent of coming form the lumbar spine. It is very common and is normally attributable to either trauma or being work related
Trauma or work related
In patients that present with Red Flags be weary to the fact that it could be malignancy or inflammatory i.e a slipped disc
Very common condition
Common problem in 20-55 year olds
Risk Factors
Heavy manual labour
Psychosocial distress
Female
Poor posture
Smoking
Sudden acute back pain in the elderly
Nocturnal pain
Below the age of 20 or older than 55
Increased pain when lying down
Neurological or alternating leg pain
History of malignancy of a history or morning stiffness
Symptoms
Signs
Sudden onset. (hasn't just been stiff on a morning)
Stiff back
Pain is unilateral but is helped with rest
Muscle spasms
Exercise aggravates pain
Scoliosis
Stability is achieved through the spinal ligaments and muscles
Therefore, the vertebrae, ligaments and muscles all can cause pain and a back problem
Spinal movement is achieved through posterior facet joints
Lumbar spondylitis
Common to happen in L5/S1 or L4/L5
It can lead to episodic spinal pain, progressive spinal stiffening or facet joint pain, all of this can lead onto acute disc prolapse and nerve irritation
Definition: this happens when a lesion occurs in the intervertebral disc of the tough capsule. This means that the disc is allowed to rotate, shrink and bend . This can be recognized on X-rays as a disc which is dehydrated and is less compliant allowing bulging of the intervertebral ligaments . This causes there to be reactive change by the adjacent vertebrae meaning that the bone becomes sclerotic and osteophytes form on the vertebrae rim .
Normally treatment is pain relief and corticosteroids!
Fibositic nodules
Postural Back pain/Pregnancy
Diagnosis