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Low Back Pain
Published in Benjamin Apichai, Chinese Medicine for Lower Body Pain, 2021
External factor: Improper use, overuse, or trauma of the lumbar region results in microscopic tears in ligaments, tendons, and/or muscles of the low back; this low back pain is called lumbar strain and is the most common cause of low back pain. The pain usually is classified as acute if it has only been present for days to weeks; it is referred to as chronic if the strain lasts longer than 3 months.
Intervertebral Disc Degeneration in Clinics
Published in Raquel M. Gonçalves, Mário Adolfo Barbosa, Gene and Cell Delivery for Intervertebral Disc Degeneration, 2018
Pedro Santos Silva, Paulo Pereira, Rui Vaz
Radicular pain, also known as nerve root pain or sciatica, is caused by nerve root compression, usually in the lateral recess of the vertebral canal or in the intervertebral foramen. This compression can be originated by osteophytes, facet joint, or yellow ligament hypertrophies, but the most common cause is a lumbar disc herniation. Radicular pain runs from the lumbar region to the lower limb, is usually unilateral and sharp, and sometimes is associated with numbness. The topography of the pain is usually well defined and depends on the affected nerve root and its respective dermatome. Since the compression is more common in L4, L5, or S1 nerve roots, the pain typically radiates below the knee, affecting the foot. Neurological examination can reveal motor weakness and sensitive alterations, depending on the myotome or dermatome of the compressed root (Table 1.2). The straight leg raising test, also called Lasègue’s test, is positive when the radicular pain is recreated by lifting the patient’s leg while the knee is extended.
Neuroanatomy overview
Published in Michael Y. Wang, Andrea L. Strayer, Odette A. Harris, Cathy M. Rosenberg, Praveen V. Mummaneni, Handbook of Neurosurgery, Neurology, and Spinal Medicine for Nurses and Advanced Practice Health Professionals, 2017
Carolina Sandoval-Garcia, Daniel K. Resnick
As shown in Figure 7.1, rostrally, the cervical spine has a lordotic curvature and is composed of seven vertebrae designated C1 through C7. The thoracic region has 12 vertebrae from T1 through T12 and has added stability provided by the sternum and rib cage (Brasiliense et al., 2011). It has a kyphotic curve. The lumbar region has five vertebrae. These are the largest vertebrae owing to the accumulated load, and this region normally has a lordotic curvature (Yoganandan et al., 2004). Both in normal and pathologic conditions, these sagittal curves arise as an evolutionary response to ambulation and erect posture. They develop progressively over time after birth as the individual develops more complex body positions and motion (Izzo et al., 2013). The more caudal aspect of the spine is the sacrococcygeal area, composed of five fused sacral vertebrae and up to four separate coccygeal bones (Yoganandan et al., 2004).
Brucellosis in older person: a case report from Qatar
Published in The Aging Male, 2022
Hanadi Khamis Al Hamad, Navas Nadukkandiyil, Mohammed Al Husami, Hebatullah Ahmed Abdelgawad, Sanjeevikumar Meenakshisundaram, Osman Bashir Nemeri
An 81-year-old Qatari Gentle man, functionally he can walk with minimal assistance and mild cognitive impairment who presented with high-grade fever with chills, anorexia, low back pain and arthralgia for 10 days. He admitted this time with pyrexia of unknown origin. Previously he was hospitalized twice and treated as community-acquired pneumonia. The above complaints were on and off for 1 month and the fever recurs intermittently. He reduced his body weight from 5 kg last 3 months. Clinical examination revealed pale appearance and local tenderness at the low lumbar region at back. There was no other localizing sign. He usually visits desert areas and had a habit of being the caretaker of camel, usually drunk its raw milk. Lab investigations revealed as high CRP 117 mg/l, Hb 9.1 g/dl and mild elevation in ALP(151 µ/l) with normal leukocyte and platelet count. His blood culture was positive for B. melitensis with high brucella antibody titter 1:1280. Other Labs PUO workups were negative. Echocardiogram did not show any vegetation. CT Chest and abdomen done due to severe Iron deficiency anemia, anorexia, and weight loss to check occult malignancy, but it was excluded. He was treated with intravenous gentamicin (7 days) and oral doxycycline (6 weeks). His blood inflammatory markers gradually reduced, and CRP was 8.5 mg/l after seven days of treatment. Anemia is corrected by parenteral iron followed by oral iron therapy. The patient was discharged after 7 days without any symptoms.
A novel frameshift variant in CEP78 associated with nonsyndromic retinitis pigmentosa, and a review of CEP78-related phenotypes
Published in Ophthalmic Genetics, 2022
Laura Lähteenoja, Sanna Häkli, Sari Tuupanen, Outi Kuismin, Tapani Palosaari, Elisa Rahikkala, Aura Falck
The patient has been diagnosed with hypothyroidism, high blood pressure, asthma, irritable bowel syndrome, spinal stenosis in the lumbar region due to disk degeneration and protrusion, and dystonia. Brain MRI at the age of 64 showed mild frontotemporomedial atrophy. At the age of 66 years, she is able to see her smartphone with visual acuities of hand motion in her right eye and 0.125 (logMAR 0.9) in her left eye and a small central field remnant of the left eye. There is alternating exotropia. The ocular fundi have pigmentary deposits and atrophic spots or patches, and the optic disks are pale, and the vessels narrow. This is demonstrated in the color and autofluorescence images of the fundi, and the appearance is seemingly similar to the fundi of her brother (Patient 1). She has problems moving around and is making use of the white cane, the guidance of her family, and absorption glasses. Her hearing is normal (Figure 2B).
Effect of dynamic stabilisation exercise therapy enhanced with muscles energy technique on some selected patients outcomes and trunk muscles function in patients with chronic non-specific low back pain: a study protocol
Published in European Journal of Physiotherapy, 2021
Usman Abba Ahmed, Thaya Nadasan, Jessica Van Oosterwijck, Sonill Sooknunan Maharaj
Low back pain (LBP) is arguably the most prevalent musculoskeletal condition found among both developed and developing nations [1,2]. Broadly defined as pain or discomfort in the lumbar region of the spine [3], it is the leading cause of activity limitations, resulting in significant losses in productivity at work and incurs billions of dollars in medical expenditure annually [415]. The prevalence of LBP worldwide is estimated to be between 30 and 80% among the general population and has been found to increase with age [6]. Besides, a higher prevalence of LBP has been associated with lower socioeconomic status and lower education levels [2,7]. According to the Global Burden of Disease (GBD) 2010 study, LBP is currently the 6th highest burden on a list of 291 conditions and is the cause of more years lived with disability globally than any other disease [2]. Affecting just about anyone, of any gender, race or socioeconomic background [8], LBP has a substantial impact on the overall and financial well-being of an individual and the society [1,8].