BACK PAIN
babesiosis
A general term covering a number of
diseases that are caused by the B
abesia
genus of
protozoa
(single-celled para-
sites). Babesiosis is mainly a disease of
animals; it may affect sheep,
cattle,
horses, and other domestic animals.
Babesiosis can be transmitted from ani-
mals to humans by tick bites, producing
symptoms similar to those of
malaria.
Treatment is with the antimalarial
drug
quinine
and an
antibiotic drug.
(See
also
ticks and disease.)
Babinski’s sign
A
reflex
movement in which the big toe
bends upwards when the outer edge
of the sole of the foot is scratched. In
babies, Babinski’s sign is a normal reflex
action. In adults, Babinski’s sign is an
indication of damage to, or disease of,
the
brain
or the
spinal cord
.
baby blues
A common name for a mild form of
depression that sometimes occurs in
women after childbirth. The baby blues
almost always disappear without treat-
ment but can occasionally develop into
a more serious depressive illness (see
postnatal depression).
baby teeth
Also known as milk teeth, an alternative
term for the first teeth (see
primary teeth).
bacillary dysentery
A type of
dysentery
(infection of the
intestinal tract) caused by bacteria of
the S
higella
genus (see
shigellosis).
bacille Calmette-Guerin
See
BCG vaccination.
bacilli
Rod-shaped
bacteria.
Bacilli (singular:
bacillus) are responsible for causing a
variety of diseases, including
infectious
diseases
such as tuberculosis, tetanus,
typhoid
fever,
pertussis
(whooping
cough), and diphtheria.
bacitracin
A type of
antibiotic drug
used in combin-
ation with other drugs to treat infections
of the eyes and skin. Bacitracin is most
commonly applied as an external skin
preparation or as eye-drops.
back
The area between the shoulders and
buttocks. The back is supported by the
spinal column (see
spine),
which is
bound together by
ligaments
(bands of
tough, fibrous tissue) and supported by
muscles that also help to control pos-
ture and movement.
DISORDERS
Back problems are numerous and may
be the result of a variety of factors
affecting the spine. They can be related
to disorders of bones, muscles, liga-
ments, tendons, nerves, and joints in
the spine, all of which can cause back
pain. (See also
spine
disorders box.)
background radiation
The small amounts of natural
radiation
that emanate from such sources as rocks
and the soil.
back pain
Most people suffer from back pain at
some time in their lives. In many cases,
no exact diagnosis is made because the
pain gets better with rest and because
analgesic drugs (painkillers) are used
before any tests, such as X-rays, are car-
ried out. In such cases, doctors may use
the term “nonspecific back pain” to
describe the condition.
CAUSES
Nonspecific back pain is one of the
largest single causes of working days
lost through illness in the UK. The peo-
ple most likely to suffer from back pain
are those whose jobs involve a lot of
heavy lifting and carrying or those who
spend long periods sitting in one posi-
tion or bending awkwardly Overweight
people are also more prone to back pain
- their backs carry a heavier load and
they tend to have weaker abdominal
muscles, which usually help to provide
support to the back.
Nonspecific back pain is thought
to be caused by a mechanical disorder
affecting one or more structures in the
back. This may be a ligament strain, a
muscle tear, damage to a spinal facet
joint, or
disc prolapse
(slipped disc).
In addition to pain from a damaged
structure, spasm of surrounding mus-
cles will cause pain and tenderness over
a wider area. This can result in tem-
porary
scoliosis
(an abnormal sideways
curvature of the spine).
Abnormalities of a facet joint and
prolapse of an intervertebral disc can
both cause
sciatica
(pain in the buttock
and down the back of the leg into the
foot). This condition is the result of
pressure on a sciatic nerve root as
it leaves the spinal cord. Coughing,
sneezing, or straining will increase the
pain. Pressure on the sciatic nerve can
also cause a
pins-and-needles
sensation
in that leg as well as weakness in mus-
cles that are activated by the nerve.
Rarely,
pain
may
radiate
down the
femoral nerve at the front of the thigh.
Osteoarthritis
in the joints of the spine
can cause persistent back pain.
Ankylosing
spondylitis
(an inflammatory disorder in
which arthritis affects the spine) causes
back pain and stiffness with loss of back
mobility.
Coccydynia
(pain and tender-
ness at the base of the spine) may occur
after a fall in which the coccyx has
struck the ground, during pregnancy, or
spontaneously for unknown reasons.
Fibrositis
is an imprecise term that is
sometimes used to describe pain and
tenderness in muscles, which may affect
the back. Fibrositis is often worse in
cold and damp weather and is occasion-
ally associated with feeling generally
unwell. Unlike other causes of back pain,
fibrositis is not accompanied by muscle
spasm or restriction of back movement.
It often improves when treated with
nonsteroidal anti-inflammatorydrugs
.
Pyelonephritis
can cause back pain as
well as pain and tenderness in the loin,
fever, chills, and pain when passing
urine. Cancer in the spine can cause
persistent back pain that disturbs sleep
and is not relieved by rest.
SELF-HELP
People with back pain and sciatica are
usually advised to remain as mobile as
possible. Sleeping on a firm mattress and
taking analgesic drugs can help to relieve
pain. However, if pain persists, is very
severe, or is associated with weakness in
a leg or bladder control problems, imme-
diate medical advice should be sought.
INVESTIGATION
Examination of the back may show ten-
derness in specific areas or loss of back
mobility Weakness or loss of sensation
in the legs implies pressure on a nerve
root, which needs prompt investigation.
X-rays of the spine may reveal nar-
rowing between the intervertebral discs;
osteoarthritis;
osteoporosis;
ankylosing
B
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