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Santosh University Journal of Health Sciences


Systemic approach to Low Back Pain and Spondyloarthritis (SpA)


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Author Details: Rakesh Kumar Jagdish, MK Bhatnagar

Volume : 2

Issue : 2

Online ISSN : 2455-1732

Print ISSN :

Article First Page : 73

Article End Page : 87


Abstract

Low back pain is most common outpatient presentation just next to common cold and leading cause of loss of productivity, morbidity and disability. There are many causes for LBA, as it is a symptom only, not a diagnosis, so it is referred as “illness in search of a disease”. Over 50%of all patients with low back pain recovers within a week time while 90%at one month without any intervention. Recurrence is quite common about 40%cases mostly within six months. It can be acute (pain less than 3 month duration), or chronic (pain more than 3 months duration), need consideration of “red and yellow flags”. Broadly it can be classified as non inflammatory(mechanical) type and inflammatory type(spondyloarthropathy). Non inflammatory causes are most common (90%) but understanding and appropriate management need to be done for inflammatory type (SpA), as it is a major cause for preventable deformities and various systemic inflammatory complications. SpA clinically has 3 components-1.Axial SpA, 2.Peripheral SpA, 3.Extra-articular manifestations of SpA. Careful understanding and accurate diagnosis needs to be done for its appropriate management and avoidance of unnecessary blood and radiological testing and finical burden on patients. Multidisciplinary approach is most appropriate in management and early recovery.

Keywords:
Low back Ache (LBA), mechanical low back pain, Red flags, Yellow flags, Spondyloarthropathy (SpA), ASAS criteria, Non radiographic SpA