Back pain history and symptoms: Difference between revisions
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==History== | ==History== | ||
*Important history question for [[patients]] presenting with [[back]] [[pain]] should include: | *Important history question for [[patients]] presenting with [[back]] [[pain]] should include:<ref name="pmid30336508">{{cite journal| author=Chenot JF| title=[Low back pain: focused history taking and physical examination]. | journal=Dtsch Med Wochenschr | year= 2018 | volume= 143 | issue= 21 | pages= 1556-1563 | pmid=30336508 | doi=10.1055/a-0634-8084 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30336508 }} </ref><ref name="pmid27723170">{{cite journal| author=Maas ET, Juch JN, Ostelo RW, Groeneweg JG, Kallewaard JW, Koes BW | display-authors=etal| title=Systematic review of patient history and physical examination to diagnose chronic low back pain originating from the facet joints. | journal=Eur J Pain | year= 2017 | volume= 21 | issue= 3 | pages= 403-414 | pmid=27723170 | doi=10.1002/ejp.963 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27723170 }} </ref> | ||
**Onset of [[pain]] (sudden or gradual) | **Onset of [[pain]] (sudden or gradual) | ||
**Duration | **Duration | ||
| Line 16: | Line 16: | ||
**[[Pain]] present at rest, during [[sleep]] | **[[Pain]] present at rest, during [[sleep]] | ||
**Changes intensity with activity or while [[sleeping]] | **Changes intensity with activity or while [[sleeping]] | ||
**Does the pain radiate elsewhere | **Does the [[pain]] radiate elsewhere | ||
**Associated symptoms | **Associated [[symptoms]] | ||
**Aggravating or relieving factors | **Aggravating or relieving factors | ||
*In general, back pain does not usually require immediate medical intervention. | *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. | *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== | ==Symptoms== | ||
*It is important to understand that back pain is a [[symptom]] of a [[medical condition]], not a [[diagnosis]] itself. | *It is important to understand that back pain is a [[symptom]] of a [[medical condition]], not a [[diagnosis]] itself.<ref name="pmid27408698">{{cite journal| author=Allegri M, Montella S, Salici F, Valente A, Marchesini M, Compagnone C | display-authors=etal| title=Mechanisms of low back pain: a guide for diagnosis and therapy. | journal=F1000Res | year= 2016 | volume= 5 | issue= | pages= | pmid=27408698 | doi=10.12688/f1000research.8105.2 | pmc=4926733 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27408698 }} </ref> | ||
*[[Back]] [[pain]] may occur by itself, or along with other [[symptoms]]. | *[[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]]). | *[[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: | *In few cases [[back]] [[pain]] can be a [[symptom]] of a serious [[medical]] condition. [[Symptoms]] to look for include:<ref name="pmid31899561">{{cite journal| author=Welk B, Baverstock R| title=Is there a link between back pain and urinary symptoms? | journal=Neurourol Urodyn | year= 2020 | volume= 39 | issue= 2 | pages= 523-532 | pmid=31899561 | doi=10.1002/nau.24269 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=31899561 }} </ref><ref name="pmid25790449">{{cite journal| author=Lumley MA, Schubiner H, Carty JN, Ziadni MS| title=Beyond traumatic events and chronic low back pain: assessment and treatment implications of avoided emotional experiences. | journal=Pain | year= 2015 | volume= 156 | issue= 4 | pages= 565-566 | pmid=25790449 | doi=10.1097/j.pain.0000000000000098 | pmc=4369787 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25790449 }} </ref><ref name="pmid8434327">{{cite journal| author=Polatin PB, Kinney RK, Gatchel RJ, Lillo E, Mayer TG| title=Psychiatric illness and chronic low-back pain. The mind and the spine--which goes first? | journal=Spine (Phila Pa 1976) | year= 1993 | volume= 18 | issue= 1 | pages= 66-71 | pmid=8434327 | doi=10.1097/00007632-199301000-00011 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8434327 }} </ref><ref name="pmid25125938">{{cite journal| author=Mabry LM, Ross MD, Tonarelli JM| title=Metastatic cancer mimicking mechanical low back pain: a case report. | journal=J Man Manip Ther | year= 2014 | volume= 22 | issue= 3 | pages= 162-9 | pmid=25125938 | doi=10.1179/2042618613Y.0000000056 | pmc=4101555 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25125938 }} </ref> | ||
**[[Intestine| | **[[Intestine|Bowel]] [[incontinence]] | ||
**[[Urinary bladder| | **[[Drug abuse]] | ||
**[[Urinary bladder|Bladder]] [[incontinence]] | |||
**Progressive [[weakness]] in [[legs]] | **Progressive [[weakness]] in [[legs]] | ||
**[[Sleep]] interrupted due to severe [[back]] [[pain]] | **[[Sleep]] interrupted due to severe [[back]] [[pain]] | ||
**[[Fever]] | **[[Fever]] | ||
**[[Depression]] | |||
**Unexplained [[weight loss]] | **Unexplained [[weight loss]] | ||
**[[Back]] [[pain]] due to [[trauma]] | **[[Back]] [[pain]] due to [[trauma]] | ||
| Line 37: | Line 39: | ||
**Repetitive intense [[exercise]] involving lumbar [[extension]] | **Repetitive intense [[exercise]] involving lumbar [[extension]] | ||
**Long term [[corticosteroid]] use (can cause [[fractures]]) | **Long term [[corticosteroid]] use (can cause [[fractures]]) | ||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
Latest revision as of 21:58, 29 May 2021
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Back pain Microchapters |
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Back pain history and symptoms On the Web |
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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.