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(See the images below.) Many of these components of the lumber spine have sensory innervation that can generate nociceptive signals representing responses to tissue-damaging stimuli. Most chronic LBP cases most likely involve mixed nociceptive and neuropathic etiologies.Biomechanically, the movements of the lumbar spine consist of the cumulative motions of the vertebrae, with 80-90% of the lumbar flexion/extension occurring at the L4-L5 and L5-S1 intervertebral disks.However, the investigators found no significant difference in pain reduction between the 2 groups at 12 months.The severity of an acute traumatic event varies widely, from twisting one's back to being involved in a motor vehicle collision.Lambeek et al assessed the efficacy of an integrated care program for chronic LBP against that of a more conventional care program, as a means of helping patients with this condition return to work.In the study, 66 patients received integrated care from a team made up of a clinical occupational physician, a physical therapist, an occupational therapist, and a medical specialist.Members of the integrated care group achieved a full, sustainable return to work in a median period of 88 days, while the same was accomplished in the conventional care group after a median 208 days.By 12-month follow-up, the integrated care group had experienced significantly greater improvement in functional status than had the conventional care patients.
While 1 of the cohort studies reported a link between sitting at work and the development of LBP, the other investigations did not find a significant connection between a sedentary lifestyle and LBP.
The most commonly reported histories include the following: Pharmacological interventions for the relief of low back pain include acetaminophen, nonsteroidal anti-inflammatory drugs, topical analgesics, muscle relaxants, opioids, corticosteroids, antidepressants, and anticonvulsants.
For individuals younger than 45 years, mechanical LBP represents the most common cause of disability and is generally associated with a work-related injury.
The lumbar spine position most at risk for producing LBP is forward flexion (bent forward), rotation (trunk twisted), and attempting to lift a heavy object with out-stretched hands.
Axial loading of short duration is resisted by annular collagen fibers in the disk.
Mechanical low back pain (LBP) remains the second most common symptom-related reason for seeing a physician in the United States.