Browsing by Subject "low back pain"

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    Open Access
    Healthy lifestyle interventions in general practice: Part 15: Lifestyle and lower back pain
    (South African Academy of Family Physicians, 2011) Schwellnus, M P; Patel, D N; Nossel, C; Whitesman, S; Derman, E W
    Lower back pain (LBP) is one of the most common medical problems in the adult population. LBP can be defined as pain, muscle tension or stiffness that is localised below the costal margin (inferior rib cage) and above the inferior gluteal folds and that can present either with or without leg pain (sciatica), and it can be classified as “specific” or “non-specific”. LBP has a high lifetime prevalence and is associated with a substantial direct and indirect cost to the individual and society. In this review, the focus is on the identification of lifestyle risk factors and interventions that are associated with mainly non-specific chronic LBP. In addition to pharmacotherapy, the best treatment approach is exercise therapy (including physical reconditioning), psychosocial and behavioural intervention and therapeutic education. Other lifestyle changes include nutritional intervention and smoking cessation.
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    Open Access
    The profile of people reporting with low back pain to a resource poor clinic in Cape Town
    (2010) Jelsma, Jennifer; Parker, Romy; Yates, Deborah Lilian
    In order to provide targeted information regarding understanding and management of low back pain (LBP), it is necessary to understand the life situation of patients. The objective of this study was to develop a profile of patients with LBP seeking care in an under-resourced area of Cape Town.The subjects were all patients attending a community health centre with a primary diagnosis of LBP. A self-designed questionnaire was used to gather relevant information such as BMI, smoking, physical activities at home and work and potentially stressful life events. Questions about perceptions of LBP, the role of health personnel, income and employment were included. Subjects could also identify which information they would like to be given by their health care providers. Fifty subjects were interviewed, 74% were female. The mean ages were 50.7 years (SD 14.0) and 54.1 years (SD 15.1) for males and females respectively. There was a high prevalence of smoking and obesity, low levels of education, and many reported high stress levels. There were a high percentage of manual workers and the nature of their activities could put them at risk for development and exacerbation of LBP. Few people knew what to expect with regard to the likely outcome of their pain and the majority identified the need for communication about the duration, prognosis, implications and management of LBP. Conclusion: A profile developed of the typical LBP patient in this community provided valuable information, which can be utilized to develop appropriate intervention strategies.
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    The Psychometric properties of the Roland Morris Disability Questionnaire for Patients with Chronic Mechanical Low Back Pain
    (2007) Buchanan, Helen
    Purpose: Functional status measures are currently not widely used in South Africa to facilitate clinical decision-making or document treatment outcomes for patients with low back pain (LBP). This study investigated the internal consistency and clinical utility of a back-specific functional status measure, the Roland Morris Disability Questionnaire (RMDQ), and determined its ability to confirm the need for spinal fusion surgery. Method: Aretrospective, descriptive design was used with 42 patients with chronic mechanical low back pain who consulted a private Orthopaedic surgeon in Cape Town over a one year period. All patients completed the RMDQ prior to their consultation. On completion of the medical examination, a rating for surgery was determined for each patient. The completed questionnaires were analysed using Statistical Package for the Social Sciences (SPSS). Results: The mean RMDQ score was 8.6 (N=42; median=9.0; range=2-21). Cronbach’s alpha showed a high internal consistency between items (.92). A categorical principal component analysis (CATPCA) identified two distinct dimensions in the RMDQ. Item reduction improved the internal consistency and thus the construct validity of the RMDQ. There was a low correlation between the surgeon’s rating for surgery and RMDQ scores (r=.40; P<.01). Conclusion: The RMDQ shows some good psychometric properties but some adjustments could improve it. The RMDQ cannot be used to predict the need for spinal fusion surgery.