Back pain history and symptoms
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Zehra Malik, M.B.B.S[2]
Overview
Important history question for patients presenting with back pain should focus on, pain onset, duration, radiation, aggravating or relieving factors, intensity, preceding event (surgery, intense exercise, trauma), and associated symptoms including, bowel incontinence, bladder incontinence, progressive weakness in legs, sleep interrupted due to severe back pain, fever, unexplained weight loss.
History
- Important history question for patients presenting with back pain should include:[1][2]
- In general, back pain does not usually require immediate medical intervention.
- Mostly cases due to inflammation, especially in the acute phase, which typically lasts for two weeks to three months and resolves on its own without progressing.
Symptoms
- It is important to understand that back pain is a symptom of a medical condition, not a diagnosis itself.[3]
- Back pain may occur by itself, or along with other symptoms.
- Symptoms include severe low back pain that may be accompanied by muscle spasm, pain with walking, concentration of pain to one side, and no radiculopathy (radiating pain down buttock and leg).
- In few cases back pain can be a symptom of a serious medical condition. Symptoms to look for include:[4][5][6][7]
- Bowel incontinence
- Drug abuse
- Bladder incontinence
- Progressive weakness in legs
- Sleep interrupted due to severe back pain
- Fever
- Depression
- Unexplained weight loss
- Back pain due to trauma
- Increased back pain in patients with osteoporosis or multiple myeloma
- Repetitive intense exercise involving lumbar extension
- Long term corticosteroid use (can cause fractures)
References
- ↑ Chenot JF (2018). "[Low back pain: focused history taking and physical examination]". Dtsch Med Wochenschr. 143 (21): 1556–1563. doi:10.1055/a-0634-8084. PMID 30336508.
- ↑ Maas ET, Juch JN, Ostelo RW, Groeneweg JG, Kallewaard JW, Koes BW; et al. (2017). "Systematic review of patient history and physical examination to diagnose chronic low back pain originating from the facet joints". Eur J Pain. 21 (3): 403–414. doi:10.1002/ejp.963. PMID 27723170.
- ↑ Allegri M, Montella S, Salici F, Valente A, Marchesini M, Compagnone C; et al. (2016). "Mechanisms of low back pain: a guide for diagnosis and therapy". F1000Res. 5. doi:10.12688/f1000research.8105.2. PMC 4926733. PMID 27408698.
- ↑ Welk B, Baverstock R (2020). "Is there a link between back pain and urinary symptoms?". Neurourol Urodyn. 39 (2): 523–532. doi:10.1002/nau.24269. PMID 31899561.
- ↑ Lumley MA, Schubiner H, Carty JN, Ziadni MS (2015). "Beyond traumatic events and chronic low back pain: assessment and treatment implications of avoided emotional experiences". Pain. 156 (4): 565–566. doi:10.1097/j.pain.0000000000000098. PMC 4369787. PMID 25790449.
- ↑ Polatin PB, Kinney RK, Gatchel RJ, Lillo E, Mayer TG (1993). "Psychiatric illness and chronic low-back pain. The mind and the spine--which goes first?". Spine (Phila Pa 1976). 18 (1): 66–71. doi:10.1097/00007632-199301000-00011. PMID 8434327.
- ↑ Mabry LM, Ross MD, Tonarelli JM (2014). "Metastatic cancer mimicking mechanical low back pain: a case report". J Man Manip Ther. 22 (3): 162–9. doi:10.1179/2042618613Y.0000000056. PMC 4101555. PMID 25125938.