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Eight out of ten Americans will experience a backache at some point. Some specialists recommend being very conservative in managing patients with back pain. Some causes of chronic low back pain include: prostatitis, hidden food allergies, hypothyroidism, autointoxication or intestinal toxemia (self-poisoning by harmful gut bacteria), mercury toxicity (if stored in the sensory ganglia near the low back), arthritis, kidney involvement, and psychological issues.
Diagnosis & Tests Further diagnostic work is not necessary for acute back pain unless there are red flags such as:- Possible fracture (following major trauma, or minor trauma in older patients or patients who may have osteoporosis)
- Possible tumor or infection of a patient aged over 50 or under 20, a history of cancer, constitutional symptoms such as fevers, chills and weight loss, risk factors for spinal infection, recent bacterial infection, intravenous drug use or immunosuppression, pain that is worse when lying on back, or severe night-time pain.
- Possible cauda equina syndrome (saddle anesthesia, bladder dysfunction, severe or progressive neurologic dysfunction in the legs, lax anal sphincter, major motor weakness in quadriceps (knee extensors), ankle plantar flexors, evertors, and dorsiflexors (foot drop).
[JAMA. 2000;284: pp.2727-32]. |
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