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PULPOSUS
LUMBAR
by stiffness
• Pain that worsens with movement (prolonged standing or sitting,
or after walking even a short distance)
• A laugh, sneeze, or other sudden action may also intensify the
pain
• Pain that worsens from hunching forward (positions such as
slouching or hunching forward in a chair, or bending forward at
the waist)
IMAGING MODALITIES
IMAGING MODALITIES
IMAGING MODALITIES
MANAGEMENT
CONSERVATIVE
• To reduce inflammation
• NSAIDs and physical therapy are the first-line treatment modalities
• Only a very short period of rest is appropriate
• Anti-inflammatories are of some benefit (because the pain is from
inflammation of the nerve); and warm, moist heat or modalities may be helpful
• Exercises and physical therapy mobilize muscles and joints facilitate the
removal of edema and promote recovery
• Muscle relaxants may offer symptomatic relief of the acute muscle spasms,
but only in the early stages (however, they do not directly relax skeletal muscle,
and they are also sedating)
• Translaminar epidural injections and selective nerve root blocks are
the second line modalities
MANAGEMENT
SURGICAL
• To relieve the pain by decompressing the neural
elements
• However, the hope of permanently relieving the
back pain is a fantasy—a false hope
• Two categories : central decompression of the
disk and directed fragmentectomy