Definition of the condition:
Chronic Pain is described as a long lasting pain that people experience beyond a normal healing time (Hasenbring, Rusu & Turk, 2012). This time is usually up to three or six months prior to an incident (Hasenbring, Rusu & Turk, 2012). Chronic back pain can include common diagnosis of muscle spasms, back strain, or myofasical syndrome (Weiner & Nordin, 2010). There are three different types of chronic back pain; simple musculoskeletal back pain, spinal nerve root pain and serious spinal pathology (Jackson & Simpson, 2006). (Hasenbring, 2012)
Causes/ aetiology:
There is suggested evidence that a number of anatomical structures such as, bones, intervertebral discs, muscles, ligaments, joints and neural structures cause back pain (Hoy, Brooks, Blyth & Buchbinder, 2010). Degenerative Disc Disease (DDD) is a condition that is believed to cause chronic back pain (Weiner & Nordin, 2010). It occurs when there is an extrusion of disc material into the surrounding tissue (Weiner & Nordin, 2010). It is also suggested that abnormal stress of the ligaments, muscles and mechanoreceptors contribute to back pain (Weiner & Nordin, 2010). The main cause of chronic back pain has not been identified, but there are many suggested issues that are believed to contribute to chronic back pain.
Symptomology:
Simple musculoskeletal back pain has symptoms of pain in the lumbrasacral area of the back (Jackson & Simpson, 2006). The upper thighs and knees are also known to be affected (Jackson & Simpson, 2006). This pain is usually described as a dull pain (Jackson & Simpson, 2006). Spinal nerve root pain is localised down the leg, and usually continues below the knee and into the feet (Jackson & Simpson, 2006). It has been d...
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...Statistics. (2006). Musculoskeletal Conditions in Australia: A Snapshot, 2004-05. Retrieved from http://www.abs.gov.au/ausstats/abs@.nsf/mf/4823.0.55.001/
Hasenbring, M.I., Rusu, A.C., & Turk, D.C. (2012). From Acute to Chronic Back Pain: risk factors, mechanisms, and clinical implications: Oxford: OUP Oxford.
Hoy, D., Brooks, P., Blyth, F., & Buchbinder, R. (2010). The Epidemiology of low back pain. Best Practice and Research Clinical Rheumatology, 24, 769-781. http://dx.doi:10.1016/j.berh.2010.10.002
Jackson, M.A. & Simpson, K. H. (2006). Chronic Back Pain. Continuing Education in Anaethesia, Critical Care and Pain, 6(4), 152-155. http://dx.doi: 10.1093/bjaceaccp/mkl029
Weiner, S.S. & Nordin, M. (2010). Prevention and management of chronic back pain. Best Practice & Research Clinical Rheumatology, 24, 267-279. http://dx.doi:10.1016/j.berh.2009.12.001
Tadić, A., Wagner, S., Hoch, J., Başkaya, Ö., von Cube, R., Skaletz, C., ... & Dahmen, N. (2009).
Chronic pain is a long term condition, which means it cannot be cured, but the symptoms may be controlled by therapies and medications (Saxon and Lillyman, 2011). When pain is considered chronic, it lasts longer than the expected healing period and there may not be a clear cause (Kraaimaat and Evers, 2003).
The lumbar region of the human spine is a location that is very susceptible to injury and trauma. A majority of the population experience back pain at some time during their life, and although in most cases the pain subsides after a time of rest, there is an enormous need for treatment of this malady. The various types of treatment for lumbar disc herniations include a more conservative method of rest, physical therapy, and anti-inflammatory or non-steroidal drugs. A more extreme condition would require surgery to try to alleviate the symptoms. The older, more traditional surgery is a posterior laminotomy, however, newer less invasive microscopic and endoscopic surgeries been implemented to increase success and recovery time as well. Although most of these operations are performed on the posterior, anterior surgeries are also performed, depending upon the nature of the injury. While these surgeries partially remove disc material affecting the spinal cord, another type of surgery is used to remove the disc entirely and replace it with prosthetics. Still, there are alternative treatments including chiropractic care, acupuncture, and physical therapy that are increasing in popularity. Due to the sensitivity and vulnerability of the spinal cord, the diagnosis and treatments have a moderate risk of failure, and force a patient to explore numerous options to relieve pain.
The sciatic nerve is like a rope made up of several nerve roots stemming from the lower back and sacral area combining to make a nerve matrix as large as your thumb. This is susceptible to nerve compression. Since this nerve runs down the back of the thigh and lower leg it also causes leg pain. The pain can result from sitting in one position too long such as with secretaries or long haul truck drivers. Women who wear very high heels suffer from sciatic pain as well. Another well known cause of sciatic pain is a slipped or...
...tive pain management and Improvement in patients outcomes and satisfaction [Magazine]. Critical Care Nurse, 35(3), 37,35,42. Retrieved from
The word “chiropractor” has two word origins, the Greek words cheir and praxis; meanwhile, cheir means “hand” and praxis means “practice.” Also, most of the work that chiropractors do is done by hand (Pike para. 5). In 2002, going to a chiropractor was found to be the most commonly used program for therapy. Seventy-four percent, about 4 million, of people that had back pain went to a chiropractor to get treated. Among that 74 percent of people, 66 percent of them stated that they got “a great benefit” (Pike para. 9). Many chiropractors work full time but 1 out of 3 chiropractors work part time. Chiropractors work whenever their patients need them, even on w...
Currently, I am involved in a prospective cohort study with other colleagues from King Fahad Medical City that aims to study the effect of a low back care educational program on low back pain prevalence among health-care professionals.
department: Are we ever going to get better? Journal of Pain Research, 2, 5-10. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3004630/
Tests after tests including MRI’s, X-rays, and experimental procedures were performed to show I had five ruptured disks in the lower lumbar section of my back. Tedious Examination done by a group of doctors concluded I had a crippling disease of the spinal column called spinal stenosis. Spinal stenosis is a narrowing of the spinal canal that causes compression of the spinal cord. (Lohr,1) If this disease was ignored any longer, it would lead to many other problems affecting other areas of my back to help support this weakness. It was an extremely rare case for an athlete my age.
Non specific low back pain (LBP) is one of the most frequent musculoskeletal disorders associated with psychological and physical dysfunctions causi...
Harvey Simon, MD, and David Zieve, MD (2012, May 3). Back Pain and Sciatica. Retrieved
A herniated disc can be caused by trauma to the disc, but more often it occurs because of chronic deterioration, typically characterized by poor posture. Poor posture adds extra weight to the front of the intervertebral disc, forcing the nucleus pulposus out toward the spinal cord and nerve fibers.
Pain Relief – Causes of acute and/or chronic back pain may include weak stomach and/or back muscles, poor posture, spinal misalignment, and the force of compression caused by gravity. Inversion therapy is used like traction to relieve pressure on the discs and elongate the spine, which reduces the pressure on nerve roots, discs, and ligaments. All that relates to lessening back and neck pain. Sometimes those tense muscles create painful muscle spasms, which are also temporarily relieved by inversion therapy.
The most common cause of sciatica is a herniated spinal disc (aka slipped disc). When this happens, the natural cushion between the vertebra of your spine ruptures, causing the disc to push out into areas usually occupied by these nerves. The nerves are compressed, and people then experience the symptoms of pain, weakness, and numbness. Other conditions, such as spinal stenosis, spondylolisthesis, or piriformis syndrome can also cause sciatica symptoms by irritating the nerve.
Chronic pain is long lasting and does not go away when the tissue injury is healed. It has the possibility of even spreading beyond the original site of the injury. The underlying mechanism is not very well understood. It is essential to understand normal pain processing in order to understand the pathology in more detail. Normal pain processing involves receptors, nerve fibers and action potentials which help to carry the pain stimuli’s from the site of injury, up the afferent nerve, to the dorsal root ganglion which then relays the stimulus to the brain (Benoliel et al, 2012).