Back pain causes: Difference between revisions
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| [[Back pain resident survival guide|'''Resident'''<br>'''Survival'''<br>'''Guide''']] | |[[Back pain resident survival guide|'''Resident'''<br>'''Survival'''<br>'''Guide''']] | ||
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| [[File:Critical_Pathways.gif|88px|link=Back pain critical pathways]]|| <br> || <br> | |[[File:Critical_Pathways.gif|88px|link=Back pain critical pathways]]||<br>||<br> | ||
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{{Back pain}} | {{Back pain}} | ||
{{CMG}} | {{CMG}} {{AE}} {{Hilda}} {{ZMalik}} | ||
==Overview== | ==Overview== | ||
The causes of back pain can be stratified according to age. Common causes of back pain in adults under the age of 50 years include ligament [[strain]], [[nerve root]] irritation, [[spinal disc herniation]], [[degenerative disc disease]] and isthmic spondylolisthesis. Common causes in adults over the age of 50 years include [[Osteoarthritis|osteoarthritis (degenerative joint disease)]], [[spinal stenosis]], | The [[causes]] of [[back]] [[pain]] can be stratified according to [[age]]. Common [[causes]] of [[back]] [[pain]] in [[adults]] under the [[age]] of 50 years include, [[ligament]] [[strain]], [[nerve root]] irritation, [[spinal disc herniation]], [[degenerative disc disease]] and isthmic [[spondylolisthesis]]. Common causes in adults over the age of 50 years include [[Osteoarthritis|osteoarthritis (degenerative joint disease)]], [[spinal stenosis]], [[trauma]], [[cancer]], [[infection]], [[fractures]], and [[inflammatory]] [[disease]]. Non-[[anatomical]] factors can also lead to [[back]] [[pain]], such as [[Stress (medicine)|stress]], repressed anger, or [[depression (mood)|depression]]. Even if an [[anatomical]] cause for the [[pain]] is present, a coexisting [[depression]] should be treated concurrently. | ||
==Causes== | ==Causes== | ||
===Common Causes=== | |||
Common [[causes]] of [[back]] [[pain]] include:<ref name="pmid17345822">{{cite journal| author=Jandrić S, Antić B| title=[Low back pain and degenerative disc disease]. | journal=Med Pregl | year= 2006 | volume= 59 | issue= 9-10 | pages= 456-61 | pmid=17345822 | doi=10.2298/mpns0610456j | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17345822 }} </ref><ref name="pmid21393649">{{cite journal| author=Nowotny J, Nowotny-Czupryna O, Brzęk A, Kowalczyk A, Czupryna K| title=Body posture and syndromes of back pain. | journal=Ortop Traumatol Rehabil | year= 2011 | volume= 13 | issue= 1 | pages= 59-71 | pmid=21393649 | doi=10.5604/15093492.933788 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21393649 }} </ref><ref name="pmid30010966">{{cite journal| author=Oliveira DS, Vélia Ferreira Mendonça L, Sofia Monteiro Sampaio R, Manuel Pereira Dias de Castro-Lopes J, Ribeiro de Azevedo LF| title=The Impact of Anxiety and Depression on the Outcomes of Chronic Low Back Pain Multidisciplinary Pain Management-A Multicenter Prospective Cohort Study in Pain Clinics with One-Year Follow-up. | journal=Pain Med | year= 2019 | volume= 20 | issue= 4 | pages= 736-746 | pmid=30010966 | doi=10.1093/pm/pny128 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30010966 }} </ref><ref name="pmid22435016">{{cite journal| author=Katonis P, Kampouroglou A, Aggelopoulos A, Kakavelakis K, Lykoudis S, Makrigiannakis A | display-authors=etal| title=Pregnancy-related low back pain. | journal=Hippokratia | year= 2011 | volume= 15 | issue= 3 | pages= 205-10 | pmid=22435016 | doi= | pmc=3306025 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22435016 }} </ref><ref name="pmid25396073">{{cite journal| author=Idris Z, Ghazali FH, Abdullah JM| title=Fibromyalgia and arachnoiditis presented as an acute spinal disorder. | journal=Surg Neurol Int | year= 2014 | volume= 5 | issue= | pages= 151 | pmid=25396073 | doi=10.4103/2152-7806.143364 | pmc=4228496 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25396073 }} </ref> | |||
*[[Abnormal posturing]] | |||
*[[Degenerative disc disease]] | |||
*[[Depression]] | |||
*[[Discopathy]] | |||
*[[Osteoarthritis]] | |||
*[[Pregnancy]] | |||
*[[Premenstrual syndrome]] | |||
*[[Fibromyalgia]] | |||
*[[Sciatica]] | |||
*[[Spinal disc herniation]] | |||
*[[Spinal stenosis]] | |||
*[[Trauma]] | |||
===Less Common Causes=== | |||
Less common [[causes]] of [[back]] [[pain]] include:<ref name="pmid25396073">{{cite journal| author=Idris Z, Ghazali FH, Abdullah JM| title=Fibromyalgia and arachnoiditis presented as an acute spinal disorder. | journal=Surg Neurol Int | year= 2014 | volume= 5 | issue= | pages= 151 | pmid=25396073 | doi=10.4103/2152-7806.143364 | pmc=4228496 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25396073 }} </ref><ref name="pmid21193933">{{cite journal| author=Gardner A, Gardner E, Morley T| title=Cauda equina syndrome: a review of the current clinical and medico-legal position. | journal=Eur Spine J | year= 2011 | volume= 20 | issue= 5 | pages= 690-7 | pmid=21193933 | doi=10.1007/s00586-010-1668-3 | pmc=3082683 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21193933 }} </ref><ref name="pmid9196476">{{cite journal| author=Kiser TS, Mauldin CC, Grant R| title=Acute low back pain secondary to retroperitoneal hemorrhage in an elderly man. | journal=Arch Phys Med Rehabil | year= 1997 | volume= 78 | issue= 6 | pages= 664-5 | pmid=9196476 | doi=10.1016/s0003-9993(97)90434-2 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9196476 }} </ref> | |||
*[[Arachnoiditis]] | |||
*[[Cauda equina syndrome]] | |||
*[[Retroperitoneal]] [[Bleeding]]/[[Hematoma]] | |||
===Life Threatening Causes=== | ===Life Threatening Causes=== | ||
Urgent [[intervention]] is required in the following [[causes]] of [[back]] [[pain]] as they may be [[life-threatening]]:<ref name="pmid24766359">{{cite journal| author=Van Wyngaarden JJ, Ross MD, Hando BR| title=Abdominal aortic aneurysm in a patient with low back pain. | journal=J Orthop Sports Phys Ther | year= 2014 | volume= 44 | issue= 7 | pages= 500-7 | pmid=24766359 | doi=10.2519/jospt.2014.4935 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24766359 }} </ref><ref name="pmid9196476">{{cite journal| author=Kiser TS, Mauldin CC, Grant R| title=Acute low back pain secondary to retroperitoneal hemorrhage in an elderly man. | journal=Arch Phys Med Rehabil | year= 1997 | volume= 78 | issue= 6 | pages= 664-5 | pmid=9196476 | doi=10.1016/s0003-9993(97)90434-2 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9196476 }} </ref><ref name="pmid24270959">{{cite journal| author=Marcon RM, Cristante AF, Teixeira WJ, Narasaki DK, Oliveira RP, de Barros Filho TE| title=Fractures of the cervical spine. | journal=Clinics (Sao Paulo) | year= 2013 | volume= 68 | issue= 11 | pages= 1455-61 | pmid=24270959 | doi=10.6061/clinics/2013(11)12 | pmc=3812556 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24270959 }} </ref><ref name="pmid25396073">{{cite journal| author=Idris Z, Ghazali FH, Abdullah JM| title=Fibromyalgia and arachnoiditis presented as an acute spinal disorder. | journal=Surg Neurol Int | year= 2014 | volume= 5 | issue= | pages= 151 | pmid=25396073 | doi=10.4103/2152-7806.143364 | pmc=4228496 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25396073 }} </ref><ref name="pmid28044125">{{cite journal| author=Bond A, Manian FA| title=Spinal Epidural Abscess: A Review with Special Emphasis on Earlier Diagnosis. | journal=Biomed Res Int | year= 2016 | volume= 2016 | issue= | pages= 1614328 | pmid=28044125 | doi=10.1155/2016/1614328 | pmc=5156786 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28044125 }} </ref><ref name="pmid23636041">{{cite journal| author=Perrin A, Bergman C, Hart L| title=A 30-year-old industrial worker with upper back pain. | journal=Adv Emerg Nurs J | year= 2013 | volume= 35 | issue= 2 | pages= 103-9 | pmid=23636041 | doi=10.1097/TME.0b013e3182948e73 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23636041 }} </ref> | |||
*[[Abdominal aortic aneurysm]] | *[[Abdominal aortic aneurysm]] | ||
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*[[Vertebral fractures]] | *[[Vertebral fractures]] | ||
===Causes by Organ System=== | ===Causes by Organ System=== | ||
{|style="width:80%; height:100px" border="1" | {| style="width:80%; height:100px" border="1" | ||
| | | style="width:25%" bgcolor="LightSteelBlue" ; border="1" |'''Cardiovascular''' | ||
| | | style="width:75%" bgcolor="Beige" ; border="1" | | ||
[[Abdominal aortic aneurysm]], | [[Abdominal aortic aneurysm]], | ||
[[angina pectoris]], | [[angina pectoris]], | ||
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|- | |- | ||
|-bgcolor="LightSteelBlue" | |- bgcolor="LightSteelBlue" | ||
| '''Chemical / poisoning''' | |'''Chemical / poisoning''' | ||
|bgcolor="Beige"| No underlying causes | | bgcolor="Beige" |No underlying causes | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |- bgcolor="LightSteelBlue" | ||
| '''Dermatologic''' | |'''Dermatologic''' | ||
|bgcolor="Beige"| [[Pilonidal cyst]] | | bgcolor="Beige" |[[Pilonidal cyst]] | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |- bgcolor="LightSteelBlue" | ||
| '''Drug Side Effect''' | |'''Drug Side Effect''' | ||
|bgcolor="Beige"| | | bgcolor="Beige" | | ||
[[Abatacept]], | [[Abatacept]], | ||
[[acitretin]], | [[acitretin]], | ||
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|- | |- | ||
|-bgcolor="LightSteelBlue" | |- bgcolor="LightSteelBlue" | ||
| '''Ear Nose Throat''' | |'''Ear Nose Throat''' | ||
|bgcolor="Beige"| No underlying causes | | bgcolor="Beige" |No underlying causes | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |- bgcolor="LightSteelBlue" | ||
| '''Endocrine''' | |'''Endocrine''' | ||
|bgcolor="Beige"| | | bgcolor="Beige" | | ||
[[Addisons disease]], | [[Addisons disease]], | ||
[[Cushing's Disease]], | [[Cushing's Disease]], | ||
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|- | |- | ||
|-bgcolor="LightSteelBlue" | |- bgcolor="LightSteelBlue" | ||
| '''Environmental''' | |'''Environmental''' | ||
|bgcolor="Beige"| [[Cadmium poisoning]] | | bgcolor="Beige" |[[Cadmium poisoning]] | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |- bgcolor="LightSteelBlue" | ||
| '''Gastroenterologic''' | |'''Gastroenterologic''' | ||
|bgcolor="Beige"| | | bgcolor="Beige" | | ||
[[Achalasia]], | [[Achalasia]], | ||
[[cholelithiasis]], | [[cholelithiasis]], | ||
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|- | |- | ||
|-bgcolor="LightSteelBlue" | |- bgcolor="LightSteelBlue" | ||
| '''Genetic''' | |'''Genetic''' | ||
|bgcolor="Beige"| | | bgcolor="Beige" | | ||
[[Marfan syndrome]], | [[Marfan syndrome]], | ||
[[spina bifida]], | [[spina bifida]], | ||
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|- | |- | ||
|-bgcolor="LightSteelBlue" | |- bgcolor="LightSteelBlue" | ||
| '''Hematologic''' | |'''Hematologic''' | ||
|bgcolor="Beige"| No underlying causes | | bgcolor="Beige" |No underlying causes | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |- bgcolor="LightSteelBlue" | ||
| '''Iatrogenic''' | |'''Iatrogenic''' | ||
|bgcolor="Beige"| No underlying causes | | bgcolor="Beige" |No underlying causes | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |- bgcolor="LightSteelBlue" | ||
| '''Infectious Disease''' | |'''Infectious Disease''' | ||
|bgcolor="Beige"| | | bgcolor="Beige" | | ||
[[Borreliosis]], | [[Borreliosis]], | ||
[[cat scratch fever]], | [[cat scratch fever]], | ||
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|- | |- | ||
|-bgcolor="LightSteelBlue" | |- bgcolor="LightSteelBlue" | ||
| '''Musculoskeletal / Ortho''' | |'''Musculoskeletal / Ortho''' | ||
|bgcolor="Beige"| | | bgcolor="Beige" | | ||
[[Abnormal posturing]], | [[Abnormal posturing]], | ||
[[ankylosing spondylitis]], | [[ankylosing spondylitis]], | ||
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|- | |- | ||
|-bgcolor="LightSteelBlue" | |- bgcolor="LightSteelBlue" | ||
| '''Neurologic''' | |'''Neurologic''' | ||
|bgcolor="Beige"| | | bgcolor="Beige" | | ||
[[Arachnoiditis]], | [[Arachnoiditis]], | ||
[[cauda equina syndrome]], | [[cauda equina syndrome]], | ||
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|- | |- | ||
|-bgcolor="LightSteelBlue" | |- bgcolor="LightSteelBlue" | ||
| '''Nutritional / Metabolic''' | |'''Nutritional / Metabolic''' | ||
|bgcolor="Beige"| | | bgcolor="Beige" | | ||
[[Osteomalacia]], | [[Osteomalacia]], | ||
[[osteoporosis]] | [[osteoporosis]] | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |- bgcolor="LightSteelBlue" | ||
| '''Obstetric/Gynecologic''' | |'''Obstetric/Gynecologic''' | ||
|bgcolor="Beige"| | | bgcolor="Beige" | | ||
[[Cervical cancer]], | [[Cervical cancer]], | ||
[[childbirth]], | [[childbirth]], | ||
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[[salpingitis]] | [[salpingitis]] | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |- bgcolor="LightSteelBlue" | ||
| '''Oncologic''' | |'''Oncologic''' | ||
|bgcolor="Beige"| | | bgcolor="Beige" | | ||
[[Cervical cancer]], | [[Cervical cancer]], | ||
[[desmoplastic small round cell tumor]], | [[desmoplastic small round cell tumor]], | ||
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|- | |- | ||
|-bgcolor="LightSteelBlue" | |- bgcolor="LightSteelBlue" | ||
| '''Opthalmologic''' | |'''Opthalmologic''' | ||
|bgcolor="Beige"| [[Reiter's Syndrome]] | | bgcolor="Beige" |[[Reiter's Syndrome]] | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |- bgcolor="LightSteelBlue" | ||
| '''Overdose / Toxicity''' | |'''Overdose / Toxicity''' | ||
|bgcolor="Beige"| [[Bearberry]] | | bgcolor="Beige" |[[Bearberry]] | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |- bgcolor="LightSteelBlue" | ||
| '''Psychiatric''' | |'''Psychiatric''' | ||
|bgcolor="Beige"| | | bgcolor="Beige" | | ||
[[Alexithymia]], | [[Alexithymia]], | ||
[[conversion syndrome]], | [[conversion syndrome]], | ||
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|- | |- | ||
|-bgcolor="LightSteelBlue" | |- bgcolor="LightSteelBlue" | ||
| '''Pulmonary''' | |'''Pulmonary''' | ||
|bgcolor="Beige"| | | bgcolor="Beige" | | ||
[[Hantavirus Pulmonary Syndrome]], | [[Hantavirus Pulmonary Syndrome]], | ||
[[lung cancer]], | [[lung cancer]], | ||
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|- | |- | ||
|-bgcolor="LightSteelBlue" | |- bgcolor="LightSteelBlue" | ||
| '''Renal / Electrolyte''' | |'''Renal / Electrolyte''' | ||
|bgcolor="Beige"| | | bgcolor="Beige" | | ||
[[Urinary obstruction]], | [[Urinary obstruction]], | ||
[[nephrolithiasis]], | [[nephrolithiasis]], | ||
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|- | |- | ||
|-bgcolor="LightSteelBlue" | |- bgcolor="LightSteelBlue" | ||
| '''Rheum / Immune / Allergy''' | |'''Rheum / Immune / Allergy''' | ||
|bgcolor="Beige"| | | bgcolor="Beige" | | ||
[[Ankylosing spondylitis]], | [[Ankylosing spondylitis]], | ||
[[chronic inflammatory demyelinating polyneuropathy]], | [[chronic inflammatory demyelinating polyneuropathy]], | ||
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|- | |- | ||
|-bgcolor="LightSteelBlue" | |- bgcolor="LightSteelBlue" | ||
| '''Sexual''' | |'''Sexual''' | ||
|bgcolor="Beige"| No underlying causes | | bgcolor="Beige" |No underlying causes | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |- bgcolor="LightSteelBlue" | ||
| '''Trauma''' | |'''Trauma''' | ||
|bgcolor="Beige"| | | bgcolor="Beige" | | ||
[[Injury]] | [[Injury]] | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |- bgcolor="LightSteelBlue" | ||
| '''Urologic''' | |'''Urologic''' | ||
|bgcolor="Beige"| [[Acute prostatitis]] | | bgcolor="Beige" |[[Acute prostatitis]] | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |- bgcolor="LightSteelBlue" | ||
| '''Miscellaneous''' | |'''Miscellaneous''' | ||
|bgcolor="Beige"| | | bgcolor="Beige" | | ||
[[Fibromyalgia]], | [[Fibromyalgia]], | ||
[[chronic fatigue syndrome]], | [[chronic fatigue syndrome]], |
Latest revision as of 01:12, 7 April 2021
Resident Survival Guide |
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Back pain Microchapters |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Hilda Mahmoudi M.D., M.P.H.[2] Zehra Malik, M.B.B.S[3]
Overview
The causes of back pain can be stratified according to age. Common causes of back pain in adults under the age of 50 years include, ligament strain, nerve root irritation, spinal disc herniation, degenerative disc disease and isthmic spondylolisthesis. Common causes in adults over the age of 50 years include osteoarthritis (degenerative joint disease), spinal stenosis, trauma, cancer, infection, fractures, and inflammatory disease. Non-anatomical factors can also lead to back pain, such as stress, repressed anger, or depression. Even if an anatomical cause for the pain is present, a coexisting depression should be treated concurrently.
Causes
Common Causes
Common causes of back pain include:[1][2][3][4][5]
- Abnormal posturing
- Degenerative disc disease
- Depression
- Discopathy
- Osteoarthritis
- Pregnancy
- Premenstrual syndrome
- Fibromyalgia
- Sciatica
- Spinal disc herniation
- Spinal stenosis
- Trauma
Less Common Causes
Less common causes of back pain include:[5][6][7]
Life Threatening Causes
Urgent intervention is required in the following causes of back pain as they may be life-threatening:[8][7][9][5][10][11]
Causes by Organ System
Causes in Alphabetical Order
References
- ↑ Jandrić S, Antić B (2006). "[Low back pain and degenerative disc disease]". Med Pregl. 59 (9–10): 456–61. doi:10.2298/mpns0610456j. PMID 17345822.
- ↑ Nowotny J, Nowotny-Czupryna O, Brzęk A, Kowalczyk A, Czupryna K (2011). "Body posture and syndromes of back pain". Ortop Traumatol Rehabil. 13 (1): 59–71. doi:10.5604/15093492.933788. PMID 21393649.
- ↑ Oliveira DS, Vélia Ferreira Mendonça L, Sofia Monteiro Sampaio R, Manuel Pereira Dias de Castro-Lopes J, Ribeiro de Azevedo LF (2019). "The Impact of Anxiety and Depression on the Outcomes of Chronic Low Back Pain Multidisciplinary Pain Management-A Multicenter Prospective Cohort Study in Pain Clinics with One-Year Follow-up". Pain Med. 20 (4): 736–746. doi:10.1093/pm/pny128. PMID 30010966.
- ↑ Katonis P, Kampouroglou A, Aggelopoulos A, Kakavelakis K, Lykoudis S, Makrigiannakis A; et al. (2011). "Pregnancy-related low back pain". Hippokratia. 15 (3): 205–10. PMC 3306025. PMID 22435016.
- ↑ 5.0 5.1 5.2 Idris Z, Ghazali FH, Abdullah JM (2014). "Fibromyalgia and arachnoiditis presented as an acute spinal disorder". Surg Neurol Int. 5: 151. doi:10.4103/2152-7806.143364. PMC 4228496. PMID 25396073.
- ↑ Gardner A, Gardner E, Morley T (2011). "Cauda equina syndrome: a review of the current clinical and medico-legal position". Eur Spine J. 20 (5): 690–7. doi:10.1007/s00586-010-1668-3. PMC 3082683. PMID 21193933.
- ↑ 7.0 7.1 Kiser TS, Mauldin CC, Grant R (1997). "Acute low back pain secondary to retroperitoneal hemorrhage in an elderly man". Arch Phys Med Rehabil. 78 (6): 664–5. doi:10.1016/s0003-9993(97)90434-2. PMID 9196476.
- ↑ Van Wyngaarden JJ, Ross MD, Hando BR (2014). "Abdominal aortic aneurysm in a patient with low back pain". J Orthop Sports Phys Ther. 44 (7): 500–7. doi:10.2519/jospt.2014.4935. PMID 24766359.
- ↑ Marcon RM, Cristante AF, Teixeira WJ, Narasaki DK, Oliveira RP, de Barros Filho TE (2013). "Fractures of the cervical spine". Clinics (Sao Paulo). 68 (11): 1455–61. doi:10.6061/clinics/2013(11)12. PMC 3812556. PMID 24270959.
- ↑ Bond A, Manian FA (2016). "Spinal Epidural Abscess: A Review with Special Emphasis on Earlier Diagnosis". Biomed Res Int. 2016: 1614328. doi:10.1155/2016/1614328. PMC 5156786. PMID 28044125.
- ↑ Perrin A, Bergman C, Hart L (2013). "A 30-year-old industrial worker with upper back pain". Adv Emerg Nurs J. 35 (2): 103–9. doi:10.1097/TME.0b013e3182948e73. PMID 23636041.