low back pain (lbp) [ME, low + AS, baec + L, poena, penalty] , local or referred pain at the base of the spine caused by a sprain, a strain, osteoarthritis, ankylosing spondylitis, a neoplasm, or a herniated intervertebral disk. Low back pain is a common complaint and is often associated with poor posture, obesity, sagging abdominal muscles, sitting for prolonged periods of time, or improper body mechanics. ▪ OBSERVATIONS: Pain may be localized and static. It may be accompanied by muscle weakness or spasms, or it may radiate down one or both legs, as in sciatica. Pain may be initiated or increased by coughing, sneezing, rising from a seated position, lifting, stretching, bending, or turning. To guard against the pain, the person may decrease the range of motion of the spine. If an intervertebral disk is herniated, deep pressure over the interspace generally causes pain, and flexion of the hip elicits sciatic pain when the knee is extended but not when the knee is flexed (Lasègue’s sign). ▪ INTERVENTIONS: Specific treatment protocols will be dictated by the cause of the low back pain, the severity of symptoms, and the patient’s history. Muscle relaxants, tranquilizers, and antiinflammatory medications may be prescribed. Rest and exercises are frequently a component of treatment. Typically the exercise program is developed and taught by a physical therapist, chiropractor, or physiatrist. ▪ PATIENT CARE CONSIDERATIONS: Correct body mechanics, adequate and appropriate exercise, and the elimination of excess weight are emphasized.
