TMSS Medical College Journal

Background: Low back pain is not a specific disease though a common health concern worldwide. There is regional variation in its etiology and patterns of presentation. In Bangladesh, there are very limited data on this important aspect of chronic low back pain. Objective: We aimed to observe the etiology and pattern of presentation of low back pain among patients seen in our physical medicine and rehabilitation outpatient department (OPD). Materials and Methods: This was a cross-sectional study of all patients with low back pain seen at the physical medicine and rehabilitation outpatient department (OPD) of TMSS Medical College Hospital, Bogura from March 2019-August 2019. Results: There were total 306 patients seen in the study who presented with low back pain, out of them 41.2% were male and 58.8% were female. The female to male ratio was 1:1.43. Most of patients 94.6% were of 30-60 years of age group. 57.9% patients were housewives and second highest were cultivator (36.6%). Most of our patients 96.5% were hailing from outside the Bogura. The mechanical low back pain was involved in 88.5% of the patients. Lifting of heavy object was the most common 62.7% predisposing factor of low back pain. In clinical pattern, 96.5% patients presented with gradual onset, 66.4% patients had intermittent pain, 11.5% patients had inactivity stiffness and 20.4% patients had radiation of pain. Hypertension and peptic ulcer disease were two top medical co-morbidities while osteoarthritis of hip and knee was the most common associated musculoskeletal disorders. Conclusion: Chronic low back pain of mechanical origin (recurrent and chronic in a significant proportion of patients) is predominant in our study. This pattern calls for prevention as well as the early and appropriate care of the patient with low back pain.

Low back pain is a common health concern worldwide. In developed countries, the estimated prevalence of low back pain in a lifetime ranged from 30% to 79.2%.'? The disability and morbidity associated with low back pain are a significant burden. In the USA, low back pain is the second most common cause of disability in adults and the second most frequent reason for the visit to the physician or medical consultation.’ Low back pain by definition is pain in the region between the lower margin of the 12th rib and the gluteal folds with or without distal radiation to the lower extremity.* Low back pain is neither a specific disease nor a diagnostic entity rather a symptomatic manifestation of actual or potential tissue damage of varying degree of severity. The actual or potential tissue damage that results in low back pain could be mechanical (musculoskeletal strains, nerve root compression, herniated disc, and degenerative disc and joints) or non-mechanical (inflammatory conditions, infection, or tumor) in origin. According to duration of symptom low back pain is subdivided into two categories: A) acute; usually lasts a few days to few weeks, B) chronic;usually lasts >12 weeks.’ Pain as an unpleasant emotional experience implies that it can be incurred without any definable physical cause. Thus, in some cases of low back pain, nothing abnormal is found despite numerous investigations.® The physical and psychosocial factors that come to play in the etiology of low back pain are generally the same worldwide. However, the extent of involvement of these factors as well as the pattern of low back pain with respect to etiology and population characteristics varies from and within countries. The aim of this study was to determine the pattern of presentation of low back pain in OPD of Physical Medicine and Rehabilitation department.