To assess the possible causes, association with occupation and effectiveness of available treatment options for acute Low Back Ache.
Design: Prospective clinical study with one year follow up.
Methods: The study comprises of 220 patients of adolescent to elderly age presenting with acute low back ache with or without radiculopathy, participating in the study according to inclusion and exclusion criteria after getting written and informed consent, treated by conservative or operative method as per standard protocol, and evaluation of functional outcome and results were done.
Results: Out of the 220 patients studied we observed that maximum patients belonged to the upper lower class (38.17%) followed by lower class (16.81%), a finding that has been previously reported as well. Our study showed that heavy manual worker (28.17%)were the most predisposed to acute low back ache followed by medium manual worker (26.81%). Among the specific occupation the porters (16.81%), lifting and walking with heavy weights were the most predisposed to acute low back ache followed by farmers (11.36%), office goers (12.27%) (Especially persons spending long hours over computers) and labourers (08.63%). Straight leg raising test was positive in 67.72% out of which 50.45% presented with unilateral positive passive SLR test, 10% as unilateral crossed and 7.27% presented with bilateral positive passive SLR test. Laseague’s Test was also positive in 62.27%., 11.81% had a sensory impairment of L4 dermatome, 46.36% of L5 dermatome, 27.72% of S1 and 6.81% of S2 dermatome. 54.09% had involvement of extensor hallucis muscle. After a follow up period of 1 year all the patients were able to walk, 4.43% of patients had pain doing routine activities, 11.24% of patients complained of pain even on slight exertional activity and 16.89% had pain only after >2hrs of exertional activity. 71.52% of patients were able to do normal routine and exertional activities.
Conclusion: The main aim of low back pain treatment by conservative means should be the prevention instead of treatment by many drugs. A comprehensive examination of all patients of low back pain should be carried out before establishing the concrete diagnosis. Also, a proper regime of physiotherapy should be encouraged to facilitate muscle strength and tone and to increase the joint motion range. Once the acute stage has passed and the patient has been relieved of pain, proper training regarding the posture and body mechanics is very useful to enable the achievement of normal physical activity.