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Low‑Back Pain (LBP) – A Comprehensive Overview
> Disclaimer: This guide is for educational purposes only and does not replace professional medical advice, diagnosis, or treatment. If you have a new or worsening condition, please consult a qualified healthcare provider.
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1️⃣ What Is Low‑Back Pain?
Low‑back pain (LBP) refers to discomfort felt in the lumbar region of the spine (the lower back). It can be:
Acute: lasting <6 weeks
Chronic: persisting >12 weeks
Recurrent: episodes that flare up after periods of relief
Common Causes
Category Examples
Musculoskeletal Muscle strain, ligament sprain, spinal disc issues (herniation), facet joint arthritis
Neurological Nerve root compression (radiculopathy)
Vascular Rarely, arterial or venous disease affecting the back
Systemic Osteoporosis, metabolic disorders
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2. Diagnostic Work‑Up
History & Physical Examination
- Onset, character of pain (sharp, dull, burning), radiation to legs/sciatica, aggravating/relieving factors.
- Red flags: fever, weight loss, progressive weakness, bowel/bladder dysfunction.
Imaging
- Plain radiographs (anteroposterior & lateral) → rule out fractures, degenerative changes.
- MRI of lumbar spine → gold standard for disc herniation, spinal stenosis, or nerve root compression.
Laboratory Tests
- CBC, ESR/CRP if infection/inflammation suspected.
- Routine metabolic panel (renal function) before contrast imaging.
Electrodiagnostic Studies
- EMG/NCS may be considered if motor/sensory deficits persist or worsen.
3. Initial Management Plan
Category Intervention Rationale
Analgesia / Symptom Relief Ibuprofen 400 mg PO q6h PRN (max 2400 mg/day) or acetaminophen 650 mg PO q6h if NSAID contraindicated. Reduces pain, inflammation; first‑line for mild to moderate symptoms.
Antispasmodic / Neuropathic Pain Gabapentin 100 mg PO at bedtime, titrate up to 300 mg nightly over 2–3 days as needed. Addresses neuropathic component (e.g., burning, tingling).
Adjunctive Measures Apply topical lidocaine patches (5%); warm compresses; gentle stretching of hand muscles; avoid activities that provoke symptoms. May reduce symptom severity and improve comfort.
Monitoring & Follow‑up Reassess in 2–4 weeks to evaluate response; adjust doses or add medications if inadequate relief. Ensure progression toward resolution and detect any complications early.
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Key Take‑away
Surgical repair is not required for a superficial, small laceration of the median nerve.
Provide pain control, protective care, and monitor for spontaneous healing.
Re‑evaluate after 2–4 weeks; if symptoms persist or worsen, consider imaging (ultrasound) and referral to a hand surgeon.
This approach balances prompt symptomatic relief with the expectation that minor median‑nerve injuries will resolve without operative intervention.
