2.1. Spine - Mechanical Back Pain Flashcards
What is the cost to the NHS of Back Pain?
£900 million
(1% of all NHS costs)
(>25% cost is in primary care)
What percentage of GP referrals to Orthopaedic outpatients is due to back pain?
21%
How common is back pain?
Very common
80% of people will suffer from it at some point
What are the 5 Categories of causes of Back Pain?
- Spondylogenic - Neurogenic
- Viscerogenic
- Vascular
- Psychogenic
What are the 3 types of Back Pain Syndromes?
Note - this is not the 4 categories of causes of back pain
- Mechanical Back Pain
- Back Pain with Nerve Root Pain
- Serious Pathology
What is the most common Back Pain Syndrome?
Mechanical Back Pain
How is Mechanical Back Pain initially managed?
- Reassurance
- Simple Analgesia Regularly
- Avoid Bed Rest / Keep Active
- Return to work with Explanation
What is the curative / recurrence rate of Mechanical Back Pain?
- 90% will settle in 6 weeks
2. 60% will recur
How is Mechanical Back Pain which fails to settle managed?
- Physiotherapy
- Consider Alternative Therapy
- Consider Facet Joint Injections
- Accupuncture
What is Back Pain commonly related to?
The workplace - physical work
What is the way forward to treating the increasing cases of back pain, and folk missing work due to it?
- Discourage the idea that Back Pain is a Disease
- Get people fit again (activity + reduce weight)
- Avoid causative activities
- Understanding psychology better (family dynamics, workplace problems, litigation etc.)
- Understand the pathology better (Cause, difference in people)
What structures may be diseased, causing back pain?
- Skin / Fascia / Fat
- Muscle / Ligaments / Tendons
- Disks / Bone / Joints
- Dura / Nerves / Vessels
- Abdominal Contents
What is the treatment for Persistent Back Pain?
- Rehabilitation Programme
- Pain Clinics
- Surgery (Very Rarely Indicated)
