General Internal Medicine,

General Internal Medicine,

References

Atlas, Steven J,M.D., M.P.H., & Deyo, Richard A,M.D., M.P.H. (2001). Evaluating and managing acute low back pain in the primary care setting. Journal of General Internal Medicine, 16(2), 120-31. doi:http://dx.doi.org/10.1111/j.1525-1497.2001.91141.x

Balagué, F., Mannion, A. F., Pellisé, F., & Cedraschi, C. (2007). Clinical update: Low back pain. The Lancet, 369(9563), 726-8. doi:http://dx.doi.org/10.1016/S0140-6736(07)60340-7 (Links to an external site.)Links to an external site.

Balagué, F., Mannion, A. F., Pellisé, F., & Cedraschi, C. (2012). Non-specific low back pain. The Lancet, 379(9814), 482-91. doi:http://dx.doi.org/10.1016/S0140-6736(11)60610-7 (Links to an external site.)Links to an external site.

Reply Candace

Lower back pain is common but emergent situations could depict this sensation and may be an emergent situation. Health care providers must assess the patient thoroughly. Palpation of the affected area is essential to identify and differentiate misalignment, muscle tightness, swelling, calcium deposits, lumps and/or nodules (Simms, 2015). Differential diagnosis is essential in developing an appropriate treatment plan. This patient could have possible cauda equina syndrome which is a medical emergency. The cause of this medical emergency is multiple lumbar root compressions at the spinal cord root. Surgical decompression may be required to reduce or eliminate pressure on the nerve. Other differential diagnosis for lower back pain include muscle strains, primary spine disease, disc herniation, and degenerative arthritis. In the majority of cases, a precise diagnosis cannot be made (Dunphy, Winland-Brown, Porter, & Thomas, 2015). The history and physical along with test such as lumbar xray and MRI is neccessary. Majority of the time, symptoms will improve in about one to four weeks. Pharmacological treatment can include NSAIDs and muscle relaxants for one to two weeks. Non-pharmacological pain can include heat therapy and ice therapy. Management can also require the patient to get out of bed after two days of rest. If the primary physician cannot manage the symptoms the patient can be referred to a specialist such as neurologist and orthopedic surgeon. The neurologist can test for any brain abnormalities and diseases that affect the neurological system. The orthopedic consult can be on standby just in case the patient needs immediate surgery for compression. References

Dunphy, L., Brown, J., Porter, B., Thomas, D. (2015). Primary Care: The Art and Science of Advanced Practice Nursing. Philadelphia: F.A. Davis Company.

Simms, A. (2015). Clinical observations in the treatment of lower back pain. Journal of Chinese Medicine, 107, 39-32.