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How can we identify the pain generator?
Pain due to lumbar spine will be radiating to leg and foot. Pain due to facet joint arthropathy will be more on bending forward and on movemnets associated with tenderness on sides of the spine. Pain arising from sacroiliac joint will be more on getting up from a sitting position along with the tenderness on dimples at the back. Muscle pain will be associated with pain on activity of that particular muscle. vertebral fractures ae mostly seen in old people or in those with history of trauma.
What are the causes of low back pain?
Low back pain can be caused due to various structures involved. Firstly could be due to herniation of disc, facet jointarthropathy, sacroilliac jointarthropathy, discogenic pain, muscle tear, ligament injuries, cancer of vertebrae, vertebral fractures.
What are the treatment modalities?
Treatment includes identification of the pain generator first with simple clinical examinations. If any doubt persist then further investigations in form of X-rays, MRI scanning , CT- scan , PET SCAN in cancer patients advised. Various treatments in form of pain killers and other antineuropathic medicines, small needle injections , radiofrequency ablations, neurolysis, TENS therapy.
Which is best treatment for low back pain?
Best treatment modality depends on the duration of pain and type of pain. Long standing chronic pain requires multimodal approach to treat the pain.
Is there any permanent solution?
Needle injections followed by physiotherapy and medications will provide long term benefit. Different treatment will respond differently in patients.