Overview
How is mechanical low back pain treated?
What is mechanical low back pain?
Which clinical history findings are characteristic of mechanical low back pain?
Which tests are performed in the evaluation of mechanical low back pain?
What is mechanical low back pain?
What is the efficacy of an integrated care program for the treatment of mechanical low back pain?
What is the pathophysiology of mechanical low back pain?
What are risk factors for mechanical low back pain?
What is the role of biomechanics in the pathophysiology of mechanical low back pain?
What is the role of spondylolisthesis in the pathophysiology of mechanical low back pain?
What is the prevalence of mechanical low back pain cases in the US?
What is the global prevalence of mechanical low back pain?
What is annual cost of mechanical low back pain in the US?
What is the racial predilection of mechanical low back pain?
What is the sexual predilection of mechanical low back pain?
How does the prevalence of mechanical low back pain vary by age?
Presentation
Which clinical history findings are characteristic of mechanical low back pain?
What should be the focus of history in the evaluation of mechanical low back pain?
What are the physical presentations of pain in mechanical low back pain?
What is included in the physical exam to evaluate mechanical low back pain?
How is dermatomal sensory and reflex testing used in the evaluation of mechanical low back pain?
How is sciatic nerve tension evaluated in patients with mechanical low back pain?
Which simulation tests are performed in the evaluation of mechanical low back pain?
Which distraction tests are performed in the evaluation of mechanical low back pain?
Which regional disturbances do not correlate with anatomy in patients with mechanical low back pain?
DDX
Which conditions should be included in the differential diagnoses of mechanical low back pain?
What are the differential diagnoses for Mechanical Low Back Pain?
Workup
What is the role of lab testing in the workup of mechanical low back pain?
What is the role of imaging studies in the workup of mechanical low back pain?
What is the role of injections in the diagnosis and treatment of mechanical low back pain?
Which histologic findings are characteristic of mechanical low back pain?
Treatment
Which factors may affect the choice of treatment for mechanical low back pain?
What is the efficacy of spinal manipulative therapy in the treatment of mechanical low back pain?
What are the functional goals of treatment for mechanical low back pain?
What is the efficacy of isokinetic exercises in the treatment of mechanical low back pain?
What is included in physical therapy for acute mechanical low back pain?
What is the efficacy of high-load lifting exercise in the treatment of mechanical low back pain?
What is the efficacy of stratified primary care for treatment of mechanical low back pain?
What is the efficacy of yoga and stretching for the treatment of mechanical low back pain?
What is the role of surgery in the treatment of mechanical low back pain?
What is the role of fluoroscopy in the treatment of mechanical low back pain?
What are the guidelines definitions of types of mechanical low back pain?
What are the Philadelphia Panel treatment guidelines for mechanical low back pain?
What are other American Pain Society (APS) treatment guidelines for mechanical low back pain?
Medications
What is the role of medications in the treatment of mechanical low back pain?
Which medications in the drug class Opioids are used in the treatment of Mechanical Low Back Pain?
Follow-up
What is included in outpatient care of mechanical low back pain?
When is inpatient care indicated for the management of mechanical low back pain?
Which medications are used in the treatment of mechanical low back pain?
When is patient transfer indicated in the treatment of mechanical low back pain?
What are measures for prevention of mechanical low back pain?
How is mechanical low back prevented?
Which occupations increase the risk for mechanical low back pain?
What is the prognosis of mechanical low back pain?
What is included in patient education about mechanical low back pain?
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Magnetic resonance image of the lumbar spine. This image demonstrates a herniated nucleus pulposus at multiple levels.
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Diskogram showing examples of an intact disk and a disrupted disk at the lumbar level.
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Sagittal magnetic resonance image showing loss of intervertebral disk height at L5/S1. Herniations of the nucleus pulposus are noted at L4/5 and L5/S1.
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Degenerative changes of the lumbar spine, including decreased signal intensity and disk bulging at the L-3/4, L-4/5 and L-5/S-1 disks.
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The process of disk degeneration following internal disk disruption and herniation.
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The various forces placed on the disks of the lumbar spine that can result in degenerative changes.