Back pain

BACK PAIN Patient information and advice: General advice: - Restrict yourself to light activities for 2-4 days. - Do not stay in bed; maintain light activities, such as walking; you can lie flat regularly through the day for brief periods (15-20 minutes). - Avoid prolonged sitting, lifting, running, and jumping. - If an injury caused the pain, use ice packs for the first 24 hours, then use heat (warm showers, electric heating pads, wheat bags, hot towels) for 20-30 minutes every 2 hours for 48 hours. Take care to avoid burns. - Take regular pain-relieving medication such as paracetamol (acetaminophen) or non-steroidal anti-inflammatory (NSAID) - avoid NSAIDs if you are < 20 years old or have kidney or stomach problems. - Use topical (rub-in) anti-inflammatory medication such as diclofenac (Voltaren), rub well into the painful area according to the directions (usually 3-4 times a day). - Sleep with your legs flexed - either on your side or on your back with a pillow under your knees. Get medical help if any of these occur: - Pain has not improved after 3-4 days. - Pain is worsening. - Pain radiates to a leg (especially if below the knee), or there is weakness, tingling or numbness of a leg. - Loss of bowel or bladder control. - Fever, frequent urination, and blood-stained urine.

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Back pain is a non-specific term usually applied to pain in the spine from the thoracic to the lumbosacral regions.

DDx

• Scoliosis
• Scheuermann's disease
• Osteoarthritis (osteoarthrosis)
• Disc lesions - annular tears, protrusions
• Pars defects - including spondylolisthesis
• Osteomyelitis
• Discitis
• Fractures
  • Non-pathological
  • Pathological - osteoporosis, malignancy
• Ankylosing spondylitis
• Paget disease
• Gout
• Primary malignancy
• Secondary malignancy (in some cases this is a paraneoplastic phenomenon)
• Referred pain from
  • Endometriosis
  • Ovarian pathology - cyst, torsion
  • Pregnancy - including tubal ectopic
  • Uterine pathology
  • Pyelonephritis
  • Renal or biliary colic
  • Prostatitis
  • Pancreatitis
  • Crohn's disease / ulcerative colitis
  • Mesenteric adenitis

Related items

• Lumbar spine

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