Section I: INTRODUCTION
1. Introduction to Low Backache ...............................3
• How is Backache Different from other Diseases? 3
• What is the Best Way to Deal with Back Pain 5
• Design of Your Back 6
• Functions of Your Spine 15
• Everything You Need to know about Human Posture 18
• Your Life Day in and Day Out 19
• Also Consider other Factors Burdening Your Kpine 20
• Welcome to the World of Backaches 20
• Low Backache 21
Section II: UNCOMMON BACKACHE
2. Uncommon Causes for Low Backaches ...................27
• Low Backache due to Reasons Related to Your Spine 27
• Low Backache due to Reasons Unrelated to Your Spine 30
• Presentation in other Uncommon Causes of Low Backache 31
• Presentations in Uncommon Causes of Back Pain (A Quick Recap) 32
3. Spina Bifi da (Occulta and Manifesta) .................. 34
• Spina Bifi da Occulta 34
• Spina Bifi da Aperta of Manifesta 35
• Relevant History 37
• Relevant Clinical Findings 37
• Investigations 42
• Treatment in a Nutshell 44
4. Ankylosing Spondylitis .......................................... 45
• Relevant History 46
• Clinical Findings 46
• Extra-articular Features 46
• Treatment in a Nutshell 48
5. Scoliosis ............................................................... 50
• Relevant History 52
• Relevant Clinical Findings 52
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Low Back Pain
• Relevant Investigations 60
• Treatment in a Nutshell 3 0’s 60
6. Osteoporosis .......................................................... 61
• Causes 61
• Clinical Features 62
• Investigations 63
• Management of Osteoporosis 64
• Anti-fall Measures in Osteoporosis 67
7. Spondylolisthesis ................................................... 69
• Relevant History 71
• Relevant Clinical Findings 72
• Relevant Investigations 74
• Treatment in a Nutshell 74
• Differential Diagnosis 75
8. Seronegative Spondyloarthropathies ..................... 76
• Introduction 76
• Etiology 76
• Signs and Symptoms 77
• Diagnosis 77
• Treatment 79
9. Lumbar Spondylosis and Lumbar Canal Stenosis ...80
Lumbar Spondylosis 80
• Risk factors 80
• Diagnosis 81
• Treatment 81
• Relevant Investigations 82
Lumbar Canal Stenosis 84
• Defi nition 84
• Classifi cation 84
• Relevant History 86
• Relevant Clinical Findings 86
• Relevant Investigations 87
• Differential Diagnosis 87
• Treatment in a Nutshell 87
10. Old Thoracic and Thoracolumbar Injuries .......... 88
• Relevant History 90
• Relevant Clinical Findings 90
Cauda Equina Syndrome 94
• Relevant History 96
• Investigations 96
• Treatment in a Nutshell 96
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Contents
11. Tuberculosis Spine ................................................ 97
Sites of Involvement within the Vertebra 97
Section III: COMMON BACKACHE
12. Intervertebral Disk Prolapse ................................109
• Disk Physiology 109
• Natural History of Lumbar Disk Disease 111
• Etiology of Disk Herniation 111
• Defi nitive Causes 113
• Relevant History 113
• Relevant Findings 119
• Differential Diagnosis 123
• Relevant Investigations 123
• Treatment in a Nutshell 123
13. Common Causes for Low Backache ....................124
• Sudden Insults to your Back 124
• Gradual Insults to your Back 127
• Summary of the Reasons for Common Low Backache 135
• Features of Common LBA 138
• Differential Diagnosis of Common Low Back Pain 140
• Slipped Disk 141
• Various Investigations in Low Backache 142
• Treatment Options 144
• You as your Doctor 149
• Exercise your Backache Away 167
• Exercises Recommended for the Back 169
• Yoga 175
• Other Useful Measures to Counter Low Backache 177
• Do these and Backache will Visit you Less Often 177
• Treatment Measures you can Safely Practice 179
• Self-Treatment Methods you can Safely Practice 182
• When to see a Doctor? 182
• Backache in Special Situations 183
• School Bag Syndrome 188
• Repetitive Stress Injury (RSI) 190
Index ..............................................................................................191