This document discusses acute back pain, including its classification, common causes, treatment options, and ways to prevent re-injury. Acute back pain is defined as lasting less than 4 weeks and is often caused by sleeping positions, poor posture, heavy backpacks, stress, or incorrect lifting. Common treatments include rest, heat/cold therapy, over-the-counter pain medications, and exercise. Preventing re-injury involves strengthening core muscles, maintaining a healthy lifestyle, and avoiding activities that could cause pain to return.

1. Acute back
pain
by Thomas Lemon, Cardiff
University

2. Aims
 Classification of acute back pain
 Importance of acute back pain
 Identify common aetiology of acute back pain
 Identify RED FLAG symptoms
 Identify treatment possibilities
 Ways to avoid re- injury

3. Classification
 Acute – less than 4 weeks
 Sub acute – 4-12 weeks
 Chronic – greater than 3 months
ALSO anatomically
- Neck pain
- Upper back pain
- Lower back pain

4.  Leading cause of disability in American under
45s

5. Bigger picture – things to
consider…
 Economical aspects – disability of workforce
 Sick days
 Quality of work carried out when suffering
pain

6. Common causes
 Sleeping position
 Poor posture
 Carrying a heavy backpack
 Stress and muscle tension
 Incorrect lifting
 Sudden physical exertion
 Accidental

7. Backpacks

8. Also
 Lack of muscle tone
 Excess weight
 Pregnancy
 Arthritis ( Chronic)

9. RED FLAGS
 Numbness or difficulty moving extremities
 Impaired bladder control
 Fever or severe headache
 60+ and history of long term steroid use
 MI or angina symptoms
 Pregnancy
 No improvement within 72 hours

10. Treatment
 Home remedies
 Hot and cold compresses
 NSAIDS, aspirin, ibuprofen, acetaminophen
or naproxen sodium
 Bed rest IS NOT best
 Slow movement is important to good recovery

11. Preventing re-injury
Exercise
 Cardiovascular
 Stretching
 Core strengthening

12. A Healthy Lifestyle
 Nutrient rich diet
 Avoid smoking and excessive alcohol
 Maintain a healthy BMI
 Drink lots of water

13. Quiz
 A 39 year old care worker presents with acute
back pain and right sided buttock pain
following lifting a patient. O/E he has reduced
R leg raising. Neurological examination
normal.
 A- Spinal stenosis
 B-Ankylosing spondylitis
 C- Prolapsed interverbebral disc

14. Quiz
Answer - Prolapsed intervertebral disc
Why?
Neuro signs after examination are present sometimes -
otherwise only localised pain due to neural root irritation
leading to pain in affected dermatome.
Pain would usually be L4/5 or L5/S1 as most common
sites of injury.
Posterior herniation = Cauda Equina compression

15. Key References
 Borenstein DG, O'Mara JW, Boden SD, et al. (2001). "The value of magnetic resonance imaging of the lumbar
spine to predict low-back pain in asymptomatic subjects: a seven-year follow-up study". J Bone Joint Surg
Am 83-A (9): 1306–11.
 Burke,G.L.,MD, (1964). Backache: From Occiput to Coccyx. Vancouver, BC: Macdonald Publishing.
"Back Pain Exercises Routine Benefits". Retrieved June 18, 2012
 ^ Hayden J, van Tulder M, Malmivaara A, Koes B (2005). "Exercise therapy for treatment of non-specific low
back pain.". Cochrane Database Syst Rev (3):
CD000335.DOI:10.1002/14651858.CD000335.pub2. PMID 16034851.
 Jensen MC, Brant-Zawadzki MN, Obuchowski N, Modic MT, Malkasian D, Ross JS (1994). "Magnetic
resonance imaging of the lumbar spine in people without back pain". N Engl J Med 331(2): 69–73
 Patel, A.. "Diagnosis and Management of Acute Low Back Pain". American Academy of Family Physicians.
Retrieved July 12, 2012
 Roelofs PDDM, Deyo RA, Koes BW, Scholten RJPM, van Tulder MW (2008). "Non-steroidal anti-inflammatory
drugs for low back pain.". Cochrane Database Syst Rev
 Savage RA, Whitehouse GH, Roberts N (1997). "The relationship between the magnetic resonance imaging
appearance of the lumbar spine and low back pain, age and occupation in males". Eur Spine J 6 (2): 106–14.
 White AA, Gordon SL (1982). "Synopsis: workshop on idiopathic low-back pain". Spine 7 (2): 141–9.
Author does not own rights to any images in the presentation.