Lower back pain

Patient

Q: Hi my parther put his back by lifting a 60kg aircon without bending his knee and been in pain in his lower back. He went to a chriopractic yeserday and the chiropratic winded him nd made the pain much worst now his whole back hurts. The chiro told him he needs to come before it feels better but he was in so much pain last night im not sure if its a good idea?

Doctor

A:   On reviewing the information you have provided about the back pain of your partner, it seems most likely that the cause is a musculo-skeletal strain. Back pain is a very common cause for a visit to a doctor and upto 84 percent of adults have low back pain at some time in their lives.
Uncomplicated acute low back pain is a self-limited condition that requires no imaging or laboratory studies. A history and physical exam alone are sufficient to evaluate most patients with back pain of less than four weeks duration
Since I do not see any risk factors like smoking, obesity, older age, physically strenuous work or sedentary work that may worsen the back pain, the outcome of low back pain in your partner is favorable.
I would advise the following for your partner :
i) Rest with activity modification : I would advise that your partner refrain from activities that cause strain to the lower back. Your partner should be encouraged to walk and resume normal daily activities as early as possible. However, I would not advise any exercise that specifically target the back. Once the acute phase has subsided, exercise may then be continues.
ii) Medical management : Use of nonsteroidal antiinflammatory drugs (NSAIDs) - advil/motrin, in acute low back pain will help relieve the pain. Centrally-acting skeletal muscle relaxants may provide skeletal muscle relaxation or relief of spasm
iii) Spinal manipulation therapy provided by a chiropractor which may involve low-velocity mobilization or manipulation with a high velocity thrust has been known to help in the management of acute low back pain. I would recommend twice weekly manipulation for two to three weeks and no longer than one month if your partner is not improving.
iv) Application of heat to the lower back using hot water bottles, hot towels, hot baths, heat wraps, electric heating pads, or infrared heat lamps may significantly reduce pain within 4-5 days in patients with acute back pain.

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