Back Pain - Signs and symptoms

Cervical and lumbar pain:Patient history should include the following data:-Exacerbation of pain with movement or prolonged special position-Determination of the duration of pain-If pain is relieved or disappears to stretching in bed-Determination of onset of acute or chronic pain-If the pain is worse at night or morning-Identify a precipitating factor.
The physical examination includes:Observing the patient walk-Back-inspection for signs of asymmetry, lesions, scars and traumaChest-assessment for ankylosing spondylitis expensiuniiThe measurement of spinal flexibilityLeg-length measurement-Evaluation of muscle strength in lower extremities-Reflexes and sensory testing.
The vote to identify systemic symptoms: fever, weight loss, dysuria, cough, or bowel and bladder dysfunction. Exclusion of drugs that contribute to the symptoms: steroids or anticoagulants.Physical examination of a patient with back pain include assessment of spinal movements and neurologic examination. It will exclude intra-abdominal pathology. It will perform rectal exam to men over 50 years to exclude prostatitis, to assess rectal tone and perineal sensitivity. Perform pelvic examination in women complaining of menstrual disorders and vaginal debacluri.
The clinical picture in the herniated disc:Patients may only leg raising test positive. Clinical presentation includes corresponding dermatome distribution tingling with the affected disc, along with muscle weakness and loss of reflexes.Herniated disks shows different presentations depending on location:-L4-over leg pain, poor foot extension of the knee, above knee sensory loss-L5-over leg pain, poor dorsiflexie leg, sensory loss in haluce-S1-pain along the posterior face of the foot, weak plantar flexion, sensory loss to the plant side and back of the leg, ankle reflex loss.
The clinical picture in spinal stenosis:Patients experience pain on the progressive side of the foot during ambulatiei-pseudoclaudicatie. This pain does not result from the failure and neurological compression pressure that cause claudication.
The clinical picture in osteomyelitis:Items are non-specific clinical and patient can be afebril. Classic presentation includes pain at palpation of the vertebral body, increased ESR. Patients at risk for osteomyelitis are those who have recently undergone spinal surgery, intravenous drug users, imunosupresatii and those with a history of pelvic inflammatory disease.
Coccidodinia:Patient history may show a fall in the direct or contusion or fracture sacrococcigiana with fracture-dislocation of the coccyx vertebrae coccigiene. Another important cause is described in history, natural birth. Cocidodinia may be due to cycling. Prolonged sitting position on the hard seats with direct pressure on coccyx. Anal intercourse was mentioned as the cause of coccidodinie.Physical examination includes palpation of the coccyx for direct sensitivity. In real coccidodinia coccygeal region is sensitive. If this is not considered to be sensitive as other diagnostic or herniated lumbar disc disease. The patient will be examined for detecting pelvic and rectal tumors.