Low Back Pain Could Be Complicated - Everything You Need To Know - Dr. Nabil Ebraheim
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- เผยแพร่เมื่อ 9 ม.ค. 2022
- Dr. Ebraheim’s educational animated video describes the condition of low back pain complicated associated condition
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Low Back Pain Could Be Complicated
• Low Back Pain Could Be...
Low back pain could be complicated
You will find no cause for low back pain in about 85% of patients. Usually the pain will go away and it 95% of the patients their pain will resolve in about 3 months. In some patients, the pain may be multifactorial or nonorganic. The pain also may be referred from other areas such as the hip joint, the buttocks, or the sacroiliac joint. The MRI may give us false positives, so study the images carefully! Correlate the images with the patient's history and physical examination. The patient may have red flags that require further investigation such as significant trauma, previous malignancy, severe progressive neurological deficit, loss of bladder and bowel control, or the patient may have systemic component such as fever, chills, or weight loss. The pain may also be referred from aortic aneurysm, renal stones, pancreatitis, pelvic diseases, duodenal ulcer, or acute myocardial infarction. Let us exclude all the situations and we ended by low back pain that originates from the spine itself, but it is not the simple one, it is complicated!
What are the scenarios?
1. Cauda equina syndrome
a. The patient will have more leg pain than back pain, but also bladder and bowel problems, incontinence, frequency, perianal numbness (these could be missed in the outcome could be catastrophic). When you see the patient, asked the patient if they have bladder or bowel symptoms and if they do, then you need to do an emergency MRI and urgent surgery. This provides the best chance for resolution of the symptoms, especially the bladder.
2. Patient has back pain with progressive neurologic deficit.
a. Study why the patient has neurologic deficit! If you cannot find the cause in the lower back, then look for it in the thoracic spine rather than neck (get MRIs). If the patient has a pacemaker, then get a myelogram with CT.
3. The patient has low back pain and gait disturbance.
a. Get an MRI of the cervical spine! Look for concomitant cervical myelopathy due to compression of the spinal cord. Careful patient selection is the key for successful outcome, especially in patients with nonspecific low back pain. Back pain is the most common Workmen's Compensation claim in the United States, accounting for 25% of all claims, and one third of all total compensation cost.
4. Worker's Compensation is an independent risk factor for unsatisfactory outcome after surgical procedure.
a. Worker's Compensation patients that are treated surgically have a poorer outcome than the general population.
5. The patient has a history of cigarette smoking.
a. Smoking affects the disc nutrition and also affects the healing of the fusion.
6. Patient has low back pain and ankylosing spondylitis.
a. This patient sometimes has an occult fracture (you can see it) and have a higher rate of neurodeficit and a higher mortality rate after surgery. You need to get an MRI or CT scan if there is significant back pain to see if there is an undiagnosed fracture, and this patient probably will need surgery if there is a fracture.
7. Patient has low back pain and an osteoporotic fracture.
a. Get DEXA scan. Provide medical treatment. In an acute fracture, you may want to give the patient a brace or surgery. If you have an older patient with a lot of pain, then get an x-ray, because you may find an osteoporotic compression fracture.
8. Patient has low back pain and depression.
a. Depression has a negative effect on the outcome after surgery.
9. Patient will need anticoagulation after surgery.
a. There is a risk-benefit and the filter may be useful in that situation.
10. The patient has neurogenic claudication (low back pain with heaviness and cramps of the calves) and sitting relieves the pain, then the patient probably has lumbar stenosis. Get an MRI, it will show you the problem and the patient would benefit from surgery on the spine.
a. This neurogenic claudication is pain and heaviness in 1 or both legs. The pain increases with an upright position and is relieved by sitting down or leaning forward. This situation is worse if you have associated vascular claudication. Patient will need vascular consult and maybe vascular surgery.
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Great,thank you.People go to Foundation Training original 12 minutes, do this every day once you are out of pain ,no backpain ever.
Dr Nabil your explanations are relateable for patients like me. It makes it easier for me to relay urgency to my GP. Thank you!!
شكرالك فهمت بعض الشيء عن الم الظهر واتمنى الترجمة للعربية لأجل الفائده للجميع بالتوفيق
Thank you...excellent information....God Bless You...
contractures, muscle strains, inflammation (overuse injuries), segmental fixations. So many common backpain problems not addressed. However, I do enjoy your videos! Thanks!
ठठठठठठठठठठठठ
Nice information about back pain. KHB
Thank you Dr🙏🏾😢
Thx .. At least I got this article Thx
Thanks video
Thanks
Thank you.
I send money to buy the pill 3 month now i cannot recieved it please give me a telephone number
TY for telling us about where/what BUT DR DIDN'T tell/explain HOW patients COULD/SHOULD do to HELP the pain🙋♀️☹☹
Spinal cord injury
THANK U SO. MUCH. DR. NABIL. I HAVE BACK. PAIN BUT IM. HOUSE MAID i dont have money for MRI how much the MRI
I appreciate your videos. They are very helpful and informative...
He has a short little blurb and can't cover everything
@@kathleenvargovich9539 kathleen, I wasnt complaining! I said I enjoy his videos. They are informative.
Glenda I didn't mean to say you we're complaining. Sorry about that.
@@kathleenvargovich9539 kathleen, im sorry. Maybe they sent your comment to me by mistake. Thanks⚘
@@glendapolich7549 no worries
Thankyou Dr Nabil fr a verygood explanation on lumbar pain. My pain is hard to find but mostly from pelvis at times localized...but on lng standing pain is more severe n runs down my leg. I know it is very costly fr the treatment ..so i am more careful n try not to stand too much . Il be watching your posts. Million thanks! God bless you.
Dr nabil good morining from pakistan 🇵🇰 i hope you will be fine ur videos so much beneficial ,but why you do not reply our worries
. I hv asked many question about my disc bulge with mild condition how can i care in futre . Remmer you in my prayer every pray time . Ithink you are a muslim. Allah look after you for ever
Each case is so different maybe he doesn't want to give you the wrong information
Wooo muy interesante 👍
Thank you so much 👍
@@kathleenvargovich9539 How would you not know this as a Chiropractor???? What school did you go to? (I am a Chiropractor)
@@ShopTherapy623 feel better about yourself now?
@@kathleenvargovich9539 hmm....I dont feel better about myself, nor was I trying to be "snotty." This is pretty basic stuff, so I'm just curious as to what school you went to, or why you are unaware of this....
Hi in your Morten’s Neuroma video from 10 years ago you mentioned lower back pain. I find that interesting as I get pain on my right hand lower back when I walk or run and struggle with MN on my left foot. Could you explain the connection and can you recommend any type of shoe
Douglas, it’s not possible to say the two are definitely related without an examination but there is a chance that you’ve developed compensatory muscle movements to minimise your MN symptoms.
For example, you could be placing greater weight on your right side to avoid your left-sided MN, which has increased the load through the right lower back.
As I say, it’s impossible to tell without an examination, therefore, I recommend you make an appointment with an accredited physical therapist for further investigation. They will also be able to provide you help and advice regarding the MN and gait patterns when walking or running.
Thank you for letting me that’s da problem I have frm now it’s very interest
So do you live in Melbourne or somewhere pls ive done my MRI scan yesterday wait for resault
E ce qeu vous pouvez faire un traduction en France ?
Merci d'avance
How can I remove rib pain
All that is explained is exactly what I am going through DR is there any cure?
Hello I am from Assam..my uncle unable to walk he need support in his arms in time of walking imblance ..like fullying drunk person..we are doing treatment in assam but no result ..will you give any idea what to do where to go..for further treatment..4yrs he Had been suffering
هل فيه علاج يرجع الدسك لوضعه الطبيعي
علاش مكاش ترجمة للعربية😭
Problem medicine?
👏👏
💝
My back pain is happening since last 4 years.. This pen goes from waist to whole leg.
Most probably slipped disc
Speck Indonesia bosku
Sir please video in hind
Можно перевод русском
👍🙋♂️🇦🇿
DO NOT get back surgery you will be at least 50% worse then you are now ,been there done that
ممكن الترجمة بللغه العربيه
Thanks