Low-Back Pain Study Sheet
Pathophysiology
Low-back pain is often caused by mechanical stress on the lumbar spine due to muscle strain, poor posture,
spinal disc problems, or degenerative changes. It can be acute (lasting days to weeks) or chronic (lasting
more than 12 weeks), and may be related to conditions like herniated discs, spinal stenosis, or osteoarthritis.
Health Promotion and Disease Prevention
- Practice good posture when sitting or standing
- Use ergonomic furniture and support
- Exercise regularly to strengthen back and core muscles
- Maintain a healthy weight
- Use proper body mechanics when lifting or bending
Assessment
Risk Factors:
- Sedentary lifestyle
- Poor posture
- Obesity
- Repetitive lifting or twisting motions
- Age-related degeneration
Expected Findings: -muscle spasms cramping and stiffness often in location
closest to the affected disk
- Pain localized in the lower back - Sciatic nerve compression causes severe pain when leg is
straightened held up and limping when walking
- Muscle stiffness or spasms - Numbness or tingling of the leg (paresthesia)
- Burning or stabbing pain in the leg or foot
- Pain that worsens with movement or prolonged sitting
- Possible radiating pain into legs
Laboratory Tests:
- Generally not required unless systemic condition suspected
- CBC, ESR, CRP if infection or inflammation suspected
Diagnostic Procedures:
- X-rays to detect bone changes
Low-Back Pain Study Sheet
-CT scan and magnetic resonance imaging to visualize bones nerves
disks ligaments spinal cord and muscles.
- MRI or CT scan for disc or nerve involvement - Bone scan provides visualization of increased vascularity indicating
tumor or infection
- Myelogram and post Myelogram CT scan show nerve root lesions or
- EMG if nerve compression suspected other lesions masses or infection.
- Electromyography EMG with nerve conduction studies: To determine
whether motor neuron issues or peripheral neuropathies are the cause.
Patient-Centered Care
Nursing Actions/Care:
- Assess pain level and functional limitations
- Encourage rest during acute episodes but promote gradual return to activity
- Apply heat or cold therapy
- Educate on posture and body mechanics
- Refer to physical therapy as needed
Medications:
1. Acetaminophen (Tylenol) - Analgesic
- Over the counter or prescription NSAID
2. Ibuprofen (Advil, Motrin) - NSAID - Tramadol can be used if NSAID are ineffective
- Oral corticosteroids decreased inflammation
3. Cyclobenzaprine (Flexeril) - Muscle relaxant - Muscle relaxants decrease muscle spasms
4. Naproxen (Aleve) - NSAID
5. Gabapentin (Neurontin) - Anticonvulsant (for nerve pain)
-Initially prescribed exercise plan following discharge
Client Education: -
- Avoid heavy lifting and twisting
- Use supportive seating
- Stretch and strengthen muscles as instructed by provider
- Follow medication instructions carefully
- Report worsening symptoms
Therapeutic Procedures: -TENS unit Can help minimize pain
- Open diskectomy
- Physical therapy and stretching routines - Surgeries for tumor or infection
- Arthrodesis/spinal fusion: Surgery to join or fuse two or more vertebrae
often required if the spine is unstable or multiple laminectomies are
- Spinal injections (e.g., corticosteroids) required (A bone graph from a pelvic bone or bone bank is used to
make a bridge between vertebrae that are next to each other; Metal
- Chiropractic care or acupuncture (as recommended) implants can also be used)
- Interbody cage fusion: Implantation of a cage like device following disk
removal
- Surgery (e.g., discectomy, laminectomy) in severe cases
Low-Back Pain Study Sheet
Interprofessional Care:
- Physical Therapist: Provides exercises and mobility strategies
- Pain Specialist: Manages chronic pain, may administer injections
- Orthopedic Surgeon: Evaluates for surgical intervention if needed
- Occupational Therapist: Assists with ergonomic and daily activity modifications
Complications
- Chronic pain and disability -Include nerve injury disk inflammation and tears to the Dura covering the spinal cord
- Cerebrospinal fluid leakage/ Examine wound dressing drainage for a halo like
- Muscle atrophy due to inactivity appearance, other manifestations include sudden headache and bulging of the incision
- Depression or anxiety
- Reduced quality of life and independence
Safety Considerations
- Teach proper lifting techniques
- Encourage gradual resumption of activity
- Fall prevention for those with mobility issues
- Monitor for side effects of pain medications
