Lumbago Research Paper

LUMBAGO:
Lumbago is a common disorder involving the muscles, nerves, and bones of the back Pain can vary from a dull constant ache to a sudden sharp feeling. Lumbago may be classified by duration as acute (pain lasting less than 6 weeks), sub-chronic (6 to 12 weeks), or chronic (more than 12 weeks). The condition may be further classified by the underlying cause as either mechanical, non-mechanical, or referred pain. The symptoms of low back pain usually improve within a few weeks from the time they start, with 40-90% of people completely better by six weeks.
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HISTORY:
At the start of the 20th century, physicians thought low back pain was caused by inflammation of or damage to the nerves, with neuralgia and neuritis frequently mentioned
The majority of LBP does not have a clear cause but is believed to be the result of non-serious muscle or skeletal issues such as sprains or strains. Obesity, smoking, weight gain during pregnancy, stress, poor physical condition, poor posture and poor sleeping position may also contribute to low back pain.
PATHOPHYSIOLOGY:
The lumbar (or lower back) region is made up of five vertebrae (L1–L5), sometimes including the sacrum. In between these vertebrae are fibro cartilaginous discs, which act as cushions, preventing the vertebrae from rubbing together while at the same time protecting the spinal cord. Nerves come from and go to the spinal cord through specific openings between the vertebrae, providing the skin with sensations and messages to muscles. Stability of the spine is provided by the ligaments and muscles of the back and abdomen. Small joints called facet joints limit and direct the motion of the spine.

The five lumbar vertebrae define the lower back
sudden pain in the lower back, a simple course of over-the-counter painkillers can help. Commonly used painkillers that are effective include non-steroidal anti-inflammatory drugs along with certain muscle relaxants. Patients are encouraged to keep themselves moving rather than take rest. Some patients find benefit from placing heated pads on the affected area. Patients are requested to sleep on a firm surface and to avoid straining themselves too much.
The medication typically recommended first are NSAIDs (though not aspirin) or skeletal muscle relaxants and these are enough for most people. Benefits with NSAIDs; however, is often small. High-quality reviews have found acetaminophen (paracetamol) to be no more effective than placebo at improving pain, quality of life, or function. NSAIDs are more effective for acute episodes than acetaminophen; however, they carry a greater risk of side effects including: kidney failure, stomach ulcers and possibly heart problems. Thus, NSAIDs are a second choice to acetaminophen, recommended only when the pain is not handled by the latter. NSAIDs are available in several different classes; there is no evidence to support the use of COX-2 inhibitors over any other class of NSAIDs with respect to benefits. With respect to safety naproxen may be best. Muscle relaxants may be