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Low Back Pain - Essay Example

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Low Back Pain (LBP) is one of the most common problems encountered in orthopedic practice nowadays as it is a condition which causes significant morbidity to the patient and is potentially disabling. It has been defined as "pain, muscle tension, or stiffness localized below the costal margin and above the inferior gluteal folds, with or without leg pain (sciatica) (MTABC, 2004)." It is important to remember that LBP is a symptom rather than a diagnosis and therefore, elucidation of the underlying cause of the back pain and its proper treatment is imperative in the treatment of back pain rather than just providing symptomatic relief to the patient.
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Download file to see previous pages LBP has been shown to impair an individual's quality of life and his/her functioning. The magnitude of the burden of this problem in the society can be gauged from the fact that the point prevalence of LBP in the general population has been reported to be 15-30% while its lifetime prevalence can be as high as 60-80% (MTABC, 2004). However, the duration of symptoms of this disorder can be reduced viz appropriate and timely management and a study conducted by Waddell et al. elucidated that almost 67% of patients who had taken time off from work due to LBP has returned to work within 1 week and within 2 months almost 90% of the patients became symptom free (MTABC 2004).
The etiology of LBP is diverse and it can be attributed to a multitude of causes including the degeneration of the lumbar intervertebral discs, spondylosis deformans (Luoma, et al., 2000 cited in Hangai et al., 2006), osteoarthritis, spinal stenosis, disc disease, dysfunction of the sacoroiliac joint, cancers, infection, organ-related pain, inflammatory arthritis (MTABC 2004), spondylolisthesis and compression fractures which commonly occur due to osteoporosis (Shirakihara, et al., 2001 cited in Hangai et al., 2006). Moreover, several studies have also reported factors such as weakness of the abdominal and back musculature (Van Tulder, et al., 2002), physical loading of the lumbar spine (Bahr, et al., 2004 cited in Hangai et al., 2006) and arteriosclerosis of the abdominal and lumbosacral arteries (Kauppila, et al., 2004 cited in Hangai et al., 2006). Interestingly, the role of psychological factors has also been implicated in the etiology of low back pain by some studies (Takeyachi, et al., 2003 cited in Hangai et al., 2006). The diversity of pathologies which can manifest as back pain often leads to difficulties in determining the underlying pathology and thus makes diagnosis challenging.
Similarly, knee pain has also been known to be triggered by a variety of factors such as obesity, increasing age and trauma. Moreover, female gender has been proven to be a definite risk factor for knee pain. Other factors such as ethnicity, smoking, osteoporosis, knee-periarticular muscle strength and exercise have also been implicated in the aggravation of pre-existing knee pain by certain studies (Fukuda and Nakamura, 2002; Burger et al., 1996; Cheng, et al., 2000 cited in Hangai et al, 2006) but these findings have not been replicated by further studies and a causal relationship between these factors and knee pain is yet to be proven.
LBP can produce a varying range of symptoms depending on the specific causes. The location and radiation of LBP varies with the pathology and some diseases may cause more back pain than leg pain while others ...Download file to see next pagesRead More
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