Low Back Pain Simple or Complicated - Everything You Need To Know - Dr. Nabil Ebraheim
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- Опубликовано: 15 дек 2021
- Dr. Ebraheim’s educational animated video describes the condition of low back pain - simple or complicated.
Check my new book, Synopsis of Orthopedic Emergencies on amazon. Here is the link.
www.amazon.com/dp/B0BQY4RNKW?...
low back pain, can be simple or complicated. It is hard to imagine anything simple associated with a disease or sickness, but low back pain can be simple. I am going to try to explain the difference between a simple low back pain situation and a complicated situation. 80% of the population will experience low back pain during their lifetime. About 3% will experience lower extremity radiculopathy. Radiculopathy could mean shooting pain down to the buttock, the posterior thigh, and the posterior leg.
It is important to ask a low back pain patient a few questions:
1. Do you have bladder and bowel symptoms?
If the answer is no, then this is good! If the answer is yes, then this could be bad, because it means the patient could have cauda equina syndrome. If the answer is yes, then you need to get an emergency MRI and you need to make sure that there is no compression of the cauda equina. If there is compression of the cauda equina then this is an emergency and you need to do an urgent surgery, otherwise the bladder function may not recover.
2. Do you stagger when you walk? Do you have unsteady gait?
If the answer is no, then this is good! If the answer is yes, "I have unsteady gait and also clumsiness in the hands ", then you should start looking at the cervical spine of the patient for another associated lesion that may cause cervical myelopathy.
3. Does the pain radiate down the leg?
If the answer is yes, then this is radiculopathy (nerve irritation associated with lumbar disc herniation). This radicular pain is usually unilateral leg pain and dermatomal.
If the patient has low back pain, 50% of the patients resolve their pain in 1 week, and 95% of the patients resolve their pain in 3 months. If you have radiculopathy, 50% of the patients recover in 1 month and 75% recover in 1 year. If you have nerve irritation and radiculopathy, then it is really more complex than if you have low back pain by itself. This radiculopathy may take a longer time to get better.
4. Ask the patient about neurogenic claudication (pain in the buttock and leg, worse with prolonged standing). If the answer is yes, then this patient probably has spinal stenosis. When the patient stands for a long time, the hyperextension of the spine makes the pain worse, and flexion of the spine improves the pain.
5. Does the patient have pain from movement of the spine?
If the answer is yes, then this is mechanical pain. This is probably better than pain that happens at rest and at night, especially if the patient has weight loss or fever, which can be associated with a tumor or infection. 50% of the new patient visits to physicians are due to low back pain, so it is a very common thing. Back pain can be idiopathic or nonspecific. In the 85% of cases, you will find no cause. Reaching a definitive, conclusive diagnosis may be difficult and 85% of patients because they may have idiopathic low back pain that does not have a cause, that will go away and the majority will get better in 3 months.
This is one of the questions that you will ask the patient, if there is more leg pain than back pain? If the patient has leg pain greater than the back pain, then the patient will have sciatica. In sciatica or lumbar radiculopathy, leg pain is greater than the back pain, especially if the disc is large or extruded. If the patient has more back pain than leg pain, then you can successfully treat the patient conservatively. Sciatica can be self-diagnosed by the patient. Sciatica means nerve root irritation probably due to a herniated disc. The disc herniation sometimes is resolved with time. The pain will be worse with sitting, coughing, sneezing, and forward flexion. The pain associated with disc herniation is less by lying down and rest. If the patient has a painful lumbar flexion, then you have a disc problem. If the patient has a painful lumbar extension, then the patient has a facet problem. When you do the examination for the patient with sciatica, you do the straight leg raise test. If the test is positive, it may indicate that the patient has a disc herniation compressing the nerve root. Disc herniation and leg pain is more complicated than low back pain alone. Another good thing that you will note from the history is that you will figure out about the risk factors. Usually, the patient is 30 to 50 years old. The cause may be occupational, with repetitive heavy lifting and driving. Be aware of things that increase the disc pressure and cause more pain. Actually, the disc pressure is the lowest in a supine position followed by standing. The worst disc pressure is when the patient is sitting and leaning forward.
As a marathon runner, amateur body builder for 17 years this is helpful. I love these videos Doctor, thank you.
As a Rehab Coach I find this video is such a precise explanation. Keep up the good work. Love your videos🙏
As a training chiropractor this is such a lovely summary. I love your videos Dr. thank you.
Thank you for the very strong descriptions of these back injuries! Well done!
This video is one of the best explanations concerning my condition. Thanks for helping me to decide on my next step.
Great video with a lot of awesome insight into a difficult topic for most clinicians and patients!
You Sir are my favorite All time teacher! Thank you so much!
You are so helpful Dr. Ebraheim! Thank you very much!
THANK YOU PROF. DR . NABIL FOR THIS EXCELLENT PERFECT VIDEO🎉🎉🎉
Great videos, thank Dr. Ebraheim 👍
Just perfect. Bravo
Excellent explanation. Helps it make sense . Thank you Dr.
Amazing video, extremely helpful and humble, really narrows down the symptoms to a particular disease. Thank you
Amazing explanation. Thank you.
Yes very clear and helpful! Love and appreciate your videos, Dr Ebraheim.
Thank you Respected Dr. indeed it is very helpful....
thanks for your explanation doctor
Highly informative a nd well explained. Thank you so much doctor.
thank you so much!
Very articulate ,simple,
Very helpful. Thank you.
This video is a masterpiece, incredible. Thank you for such an amazing work. It helped me a lot.
Very nice detailed explanation, thank ypu!
Thank you very much for this video
Thanks Sir, your videos are always informative and easy to understand
Thank you 🙏
Thanks a lot Sir
Ur explanation is always helpful - thank you sir
Maa shaa Allah great information sir 👍👌👌👌
Great sir... Salute sir
My orthopaedics doctor never check if you have depression. They just straight get an xray then MRI then send you to physical therapy if don't work send you too another doctor to check tour hips.
Thank you dr
Thank you
Thankyou doctor,
This was very helpful explanations. I have understood a lot, and it's given me positive outlook
Very nice !
Thank you.
Extremely helpful. Thank you so much
Thank you Dr,
Great sir thank you sir
very good doc
Very informative
I have a lot of odd symptoms that I have had for years now. I know I have a lot going on in my spine. Now my left leg buckles, I get really fatigued out like I’m walking thru cement,modic 1 changes(whatever that is) in my l2/3,L3:4. I don’t see a lot of info on these discs. I also have cervical spine issues so tiring and nobody has any ideas so I just suffer
thank you! I have several disc hernations with sciatica your video helps me understand my condition better
Thank,s s lot dear DR i have all type pain in my back & legs , usefull 🙏🙏
As a PAZ trooper, this video explain a lot. thanks.
❤❤❤ love it
Some of football players (soccer players) need to watch this video
Thanks
If someone has a good back then people should be grateful that their body is in a very good shape for their entire lifetime.
I suspect that women have more back pain than many men out there.
Thank you, doctor. I have lower back pain, and the pain comes from the back of the hip up to the leg from the front. It is terrible. But on some days, it relieves me, but when I equalize the movements of the bend, but the front, the pain returns.
I had an X-ray of L3L4L5S1
So what did you find in the xray?
Thanks
Very true today is my admission for operation of my L5/S1😢hernaited disc very painful
I’m happy to watch your program cos I am the one who have this problem too but I can’t understand how they do this the specialist said I have to try da needle first for da pain and I did had the MRI exray at da hospital
Please suggest the treatment of L5 S1 disk herniation...
1. Physical therapy and ongoing exercises at home. 2. Injections. 3. Surgery
Please sugest which type physio therapy is best sugedt positions. Whjvh injection is Best at L 5
@@CJ-og2yf Go see an orthopedic surgeon and they will provide you with your next move
So nice to watch this this is the problem that I have but I’ve already done X-ray MRI but they want me to do the injection to see if it help or not everything’s you explain in a video is so true to me thanks for that but I need more advice pls 🙏🏽💝
Plz suggest some treatment
Can you do one on calcification of PLL?
T12 compressor problem please tell me the exercise 🙏
Thanks a lot for this video. It is very useful .
I'd like to have Information and treatment of cysts Tarlov.
I understood that if they are bigger than 1,5 cm they can make compresion on the nervs. Mine are 2,2cm situate S1 left, S2 right and S3 bilateral.
Best wishes!
please suggest the exercise for sciatica pain relief
شكرا لحضرتك جدا دكتور
very true
Which doctor is best for LBP neurologist or orthopedic?
Treatment for children under 15 years who have sciatica please 🙏
Guess what many people just watch Athletes or Musicians and dont realize the effects of walking and pain management in 2022.
Sir on mri scan their is a large Lumbar disc herniation going downward and presented with slrt negative but mild leg pain on standing for long hours , do this patient requires surgery
Sir best excersie for L5 S1 DISC BULGE PLEASE
Plz suggest exercise & medicine for L4 L5 &s1
Doctor, any theories as to why back pain so common? Is it true that humans are unique in walking veritically and this may be the reason we have these problems?
Hello. Sir I am suffering from l4,l5 herniated disc, nerve compression of left side. Symptoms is left back paint, anxiety, depression, body weakness, mental disorder. Can you please help me to recover all these.
Dear bro tell me my brother leg no can working just feeling how I can now doctor say important to exercise?
My son have a
Arkylosing spondytis is therapy can help him to walk
I am electrician for 30
Iam 59 years old will I recover Togo back to work
My first rating 21%
Then I got fused
Getting another fce after injections
Low back pain is usually “over there” ie you have to source the problem.
Meaning Your hip rotators, esp internal hip rotators, causing the unstraightedness which causes the lower back to sort of flench up.
Lower back pain is common in my country because most jobs require being seated which is terrible for your body. You should really be keeping moving. Also commuting in those damn cars with bucket seats makes it for the worse.
Big fan of straight lines
Ty
I am suffering from a host of medical slavery complications following a traumatic incident at work over 22yrs ago, and believe me hell is a real life experience. I was to by King's college hospital London, that I have cauda equina syndrome and that was from 2016, I am in excruciating pain, my lower back is swollen, my legs are dying and the issues around my bowels and bladder was a nightmare after my injuries but now death would be a far better outcome 💔 😢
You can try spinal decompression
@@herbal-medicine-for-hair thank you so much for getting back in contact. I have been trying for several years to have one done to all my suffering as fallen on deaf ears 💔💔💔😢😢😢😢🙏🏾
@@craigfowler8297 Find some way to relieve the pain, don't give up easily, come on!
Bulging disc L3L4 L4L5on MRI , nerve conduction study said L5S1 I have bilateral spinel stenosis , facet injection didn't work epidural didn't work legs both still numb I want lower back pain also surgery NOW!!!
Wat Will Be Please
Réponse SVP Eve
Tanks Dr
Afternoon from New Mexico
I had laminectomy failed
HadL5 S1 fused
Still have low back pain right leg is numb and week
Get injections aug 29
Sacroiliac injection
🙏
Low back pain causing urination too much what does this mean?....
L3 L4,L4 L5 microdisectomy problem give me some solution,
My name is SFaifua I did have the mri scan 2 months ago because I had very pad pain and I didn’t have leg pain only my lower back usually on my left side sore very pad and they asked me to have an injection to hold da pain
Spondylolisthesis ?
24 Dec.22 I gett treatment surgery of L4 L5 S1 by .RESPECTED DR SHAHZAD SHAMAS PR DR of neuro surgery .in Lahore Pakistan OMER HOSPITAL JAIL ROAD LAHORE .
THNX TO ALLAH I m feeling well now . ALHAMDULILLAH
BEST AND PROVEN TREATMENT FOR THIS LOWER BACK PAIN USUALLY CAUSE BY BULGING DISC IS TO PRESS IT DIRECTLY WITH A THUMB FROM L1 TO L5. WORKS INSTANLY . NO NEED FOR EXPENSIVE SURGERY.
Por fabor en español
Кто нибудь объясните что он говорить??пожалуйста
❣️❣️❣️❣️❣️❣️❣️❣️❣️❣️
👍👍👍👍👍👍👍👍👍👍👍👍👍👍👍
Vdo hindi m bnaya kre
Video hindi me banaye
En,francaise
It is my m r i report
Ehhh idk
T’y
;#:il
L4l5s1herniatiedexrise
Thanks