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In acute injury resulting in lumbosacral radiculopathy, conservative treatment such as acetaminophen and NSAIDs should be the first line of therapy. [1] Therapeutic exercises are frequently used in combination with many of the previously mentioned modalities and with great results. A variety of exercise regimens are available in patient treatment.
Treatment is often dependent on the duration and severity of the pain and dysfunction. In the acute phase (first 1–2 weeks) for a mild sprain of the sacroiliac, it is typical for the patient to be prescribed rest, ice/heat, spinal manipulation, [35] and physical therapy; anti-inflammatory medicine can also be helpful. [1] [4]
The effects of injuries at or above the lumbar or sacral regions of the spinal cord (lower back and pelvis) include decreased control of the legs and hips, genitourinary system, and anus. People injured below level L2 may still have use of their hip flexor and knee extensor muscles. [ 47 ]
Back brace for support while the bone heals—either a Jewett brace for relatively stable and mild injuries, or a thoracic lumbar sacral orthosis (TLSO) for more severe ones. [5] Opioids or non-steroidal anti-inflammatory drugs (NSAIDs) for pain. For osteoporotic patients, calcitonin may be helpful. [6] [7]
Lumbar disc herniations occur in the back, most often between the fourth and fifth lumbar vertebral bodies or between the fifth and the sacrum. Here, symptoms can be felt in the lower back, buttocks , thigh , anal/genital region (via the perineal nerve ), and may radiate into the foot and/or toe .
Massage therapy does not appear to provide much benefit for acute low back pain. [1] Massage therapy has been found to be more effective for acute low back pain than no treatment; the benefits were found to be limited to the short term [118] and there was no effect for improving function. [118]
A strain is a type of acute injury that occurs to the muscle or tendon. Similar to sprains, it can vary in severity, from a stretching of the muscle or tendon to a complete tear of the tendon from the muscle. Some of the most common places that strains occur are in the foot, back of the leg (hamstring), or back. [2]
Diagnosis of a back injury begins with a physical examination and thorough medical history by health-care personnel. [8] [14] Some injuries, such as sprains and strains or herniated discs, can be diagnosed in this manner. To confirm these diagnoses, or to rule out other injuries or pathology, imaging of the injured region can be ordered.