Back pain is pain felt in the back. It may be classified as neck pain (cervical), middle back pain (thoracic), lower back pain (lumbar) or coccydynia based on the segment affected. The lumbar area is the most common area affected. An episode of back pain may be acute, subacute or chronic depending on the duration. The pain may be characterized as a dull ache, shooting or piercing pain or a burning sensation. Discomfort can radiate to the arms and hands as well as the legs or feet, and may include numbness or weakness in the legs and arms.
Pott's disease, or Pott disease, named for British surgeon Percivall Pott who first described the symptoms in 1799, is tuberculosis of the spine, usually due to haematogenous spread from other sites, often the lungs. The lower thoracic and upper lumbar vertebrae areas of the spine are most often affected.
An intervertebral disc, also spelled intervertebral disk, lies between adjacent vertebrae in the vertebral column. Each disc forms a fibrocartilaginous joint, to allow slight movement of the vertebrae, to act as a ligament to hold the vertebrae together, and to function as a shock absorber for the spine.
Sciatica is pain going down the leg from the lower back. This pain may go down the back, outside, or front of the leg. Onset is often sudden following activities such as heavy lifting, though gradual onset may also occur. The pain is often described as shooting. Typically, symptoms are only on one side of the body. Certain causes, however, may result in pain on both sides. Lower back pain is sometimes present. Weakness or numbness may occur in various parts of the affected leg and foot.
Lordosis is historically defined as an abnormal inward curvature of the lumbar spine. However, the terms lordosis and lordotic are also used to refer to the normal inward curvature of the lumbar and cervical regions of the human spine. Similarly, kyphosis historically refers to abnormal convex curvature of the spine. The normal outward (convex) curvature in the thoracic and sacral regions is also termed kyphosis or kyphotic. The term comes from Greek lordos 'bent backward'.
The psoas sign, also known as Cope's sign or Obraztsova's sign, is a medical sign that indicates irritation to the iliopsoas group of hip flexors in the abdomen, and consequently indicates that the inflamed appendix is retrocaecal in orientation.
The psoas major is a long fusiform muscle located in the lateral lumbar region between the vertebral column and the brim of the lesser pelvis. It joins the iliacus muscle to form the iliopsoas. In animals, this muscle is equivalent to the tenderloin.
The psoas minor muscle is a long, slender skeletal muscle. When present, it is located anterior to the psoas major muscle.
The quadratus lumborum muscle, informally called the QL, is a paired muscle of the left and right posterior abdominal wall. It is the deepest abdominal muscle, and commonly referred to as a back muscle. Each muscle of the pair is an irregular quadrilateral in shape, hence the name.
The iliacus is a flat, triangular muscle which fills the iliac fossa. It forms the lateral portion of iliopsoas, providing flexion of the thigh and lower limb at the acetabulofemoral joint.
Spinal fusion, also called spondylodesis or spondylosyndesis, is a surgery performed by orthopaedic surgeons or neurosurgeons that joins two or more vertebrae. This procedure can be performed at any level in the spine and prevents any movement between the fused vertebrae. There are many types of spinal fusion and each technique involves using bone grafting—either from the patient (autograft), donor (allograft), or artificial bone substitutes—to help the bones heal together. Additional hardware is often used to hold the bones in place while the graft fuses the two vertebrae together. The placement of hardware can be guided by fluoroscopy, navigation systems, or robotics.
The iliopsoas muscle refers to the joined psoas major and the iliacus muscles. The two muscles are separate in the abdomen, but usually merge in the thigh. They are usually given the common name iliopsoas. The iliopsoas muscle joins to the femur at the lesser trochanter. It acts as the strongest flexor of the hip.
Pyomyositis is a bacterial infection of the skeletal muscles which results in an abscess. Pyomyositis is most common in tropical areas but can also occur in temperate zones.
In human anatomy, the muscles of the hip joint are those muscles that cause movement in the hip. Most modern anatomists define 17 of these muscles, although some additional muscles may sometimes be considered. These are often divided into four groups according to their orientation around the hip joint: the gluteal group; the lateral rotator group; the adductor group; and the iliopsoas group.
The lumbar nerves are the five pairs of spinal nerves emerging from the lumbar vertebrae. They are divided into posterior and anterior divisions.
A disc herniation or spinal disc herniation is an injury to the intervertebral disc between two vertebrae, usually caused by excessive strain or trauma to the spine. It may result in back pain, pain or sensation in different parts of the body, and physical disability. The most conclusive diagnostic tool for disc herniation is MRI, and treatments may range from painkillers to surgery. Protection from disc herniation is best provided by core strength and an awareness of body mechanics including good posture.
Discitis, or diskitis, is an infection in the intervertebral disc space that affects different age groups. Symptoms include severe back pain, leading to lack of mobility. In adults, it can lead to severe consequences, such as sepsis or epidural abscess, but it can also spontaneously resolve, especially in children under 8 years of age. Discitis occurs post-surgically in approximately 1–2 percent of patients after spinal surgery. There is debate as to the cause. Diagnosis is usually apparent on MRI, although plain X-rays and CT examinations can be suggestive. Treatment is difficult and usually includes antibiotics. Reducing the mobility of the affected region is an occasionally recommended solution, but changes from case to case.
A laminotomy is an orthopaedic neurosurgical procedure that removes part of the lamina of a vertebral arch in order to relieve pressure in the vertebral canal. A laminotomy is less invasive than conventional vertebral column surgery techniques, such as laminectomy because it leaves more ligaments and muscles attached to the spinous process intact and it requires removing less bone from the vertebra. As a result, laminotomies typically have a faster recovery time and result in fewer postoperative complications. Nevertheless, possible risks can occur during or after the procedure like infection, hematomas, and dural tears. Laminotomies are commonly performed as treatment for lumbar spinal stenosis and herniated disks. MRI and CT scans are often used pre- and post surgery to determine if the procedure was successful.
The Thomas test is a physical examination test, named after the Welsh orthopaedic surgeon, Hugh Owen Thomas (1834–1891), to rule out hip flexion contracture and psoas syndrome.
