The role of trauma in low back pain: a review.
J Trauma Journal of Trauma 1978 Sep; 18(9):628-634
The role of trauma in low back diseases is reviewed. Studies indicate that driving a truck or tractor, driving more than 10 miles per day, and multiple pregnancies are risk factors for herniated nucleus pulposus. Individuals engaged in athletic activities such as golf, tennis, and basketball may have increased risk of herniated nucleus pulposus whereas gymnasts and interior football lineman may incur spondylolisthesis. Farmers appear to be at somewhat greater risk for low back difficulties. Mechanical forces acting on the spine such as compression, torsional loads, tension and shear loading are reviewed. The mechanical behavior of the intact spine is discussed as it relates to motion segment behavior, posture, and pain and psychologic modifying factors. Psychological factors are important in that patients with profiles of hysteria, somatization, depression and anxiety have less favorable outcomes from chymopapain injection for disc herniations. These same individuals suffer prolonged disability from low back disorders. The difficulties in making diagnoses for low back pain tend to focus on objective evidence of disease. Equally as difficult is the determination of spinal degeneration. The authors stress the helpfulness of a single AP and lateral film to assess acute low back pain under most emergency conditions, indicating that little usefulness results from oblique films which carry a high radiation exposure level.
NIOSH-Publication; NIOSH-Grant; Musculoskeletal-system-disorders; Back-injuries; Muscular-disorders; Physiological-stress; Truck-drivers; Sports-injuries; Risk-analysis; Risk-factors
Orthopaedic Surgery University of Vermont Dept of Orthopaedic Surgery Burlington, VT 05401
The Journal of Trauma: Injury, Infection, and Critical Care
University of Vermont & St Agric College, Burlington, Vermont