Low back ache is the commonest cause of disability and in 1993 in the UK 120 million days were misplaced from work through back ache. Episodes of back ache generally resolve within 4 – 8 weeks; a few have chronic problems.

Causes-

* Facet combined disease i.e. arthritis in joints in the vertebral column recognized facet joints

* Lumbar disc disintegration

* Lumbar disc prolapse

* Spondylolisthesis i.e. slipping of one vertebral body on some other below

* Spinal stenosis – narrowing of spinal canal due to degeneration causing nerve root compression

* Osteoporosis – decalcification (loss of calcium) of bone

* Rheumatiod arthritis

* Paget’s disease

* Malignancies

Symptoms-

Pain is generally between the rib cage and buttocks with possible radiation to posterior thigh. Nerve roots emerge from the vertebral canal and whether the degenerative propagation or disc dense these spinal nerve ancestry the enduring suffers from sciatica i.e. sharp shock like ache radiating down the support, generally below the knee. Elevating the leg exacerbates the sciatica. Sensory (numbness) and motor deficit (weakness) might arise in the are of the leg, which is innervated by the compressed spinal nerve root.

Investigations-

Patients with mechanical back ache shall have no radiological changes. In other cases there might be lumbar disc degeneration and or facet joint arthritis. Plain x-rays can also appear spondylolisthesis, osetoporosis or malignant bony deposits. Computerized tomography scanning or magetic resonance assume are of greater worth for diagnosis of spinal stenosis and disc prolaspe.

Treatment-

Physical treatment – mobilisation and strengthening exercises e.g. Maitland’s mobilisation and Criax and manipulative techniques might be useful. Chiropractic manipulation might also be of use.Drug dealing – non-steroidal anti-inflammatory drugs capacity being gainful but they might aggravate asthmatic attack, or cause gastric nuisance and flow. Other painkillers valor be tried; although, addictive opioid drugs should be used with extreme Injection treatment.