back pain
purepedantry | February 19, 2009
Here is a lesson in why defensive medicine should be avoided: it costs a lot, it doesn't help patients, and it has the potential to hurt them. Chou et al. published a study in the Lancet showing that in patients presenting with lower back pain without serious clinical symptoms (more on this in a second) imaging does not improve outcomes.
Lower back pain is a common presentation in clinic. It is pretty prevalent with about 15 percent of Americans reporting having had it. However, in most cases it isn't anything to be alarmed about. In the majority of cases, it goes away pretty quickly…
palmd | February 4, 2009So, what's up with low back pain? Well, here's what's up with mine:
To quote from The Book of Pal:
Just below the L4-L5 disc, behind L5 vertebral body on the
right side, there is evidence of a large extradural soft tissue density
measuring approximately 1.5 x 0.8 cm in its maximum vertical and
anteroposterior dimensions respectively. This has the appearance of a large
extruded disc fragment within the epidural space, compromising the right L5
nerve root.
And we say, "Amen."
An MRI of the lumbar spine consists of hundreds of images; I've pulled one out for you. It turns out that science is…
palmd | February 2, 2009I gotta admit that I just don't get it. Perhaps it's my overly narrow world-view, or perhaps it's my lack of imagination, but I really don't get it. Let me explain.
I've got this horrid pain in my back and leg. It's searing, aching, gnawing. My foot is numb, but still hurts. It tingles, feels heavy, and it's weak. Sometimes it feels like electricity is jumping through it, sometimes like little worms are crawling in it. Being a curious person, I look for ways to explain this.
I'm sure this horrid crawling feeling could be explained thusly:
Perhaps there are actual worms crawling…
palmd | January 29, 2009It started a few weeks ago---a dull ache in my lower back, more on the right, worse with sitting for prolonged periods of time. I did my usual stretches, although not as much as I should have. The pain waxed and waned, until a few days ago, when the pain escalated suddenly, preventing me from standing up straight, and making even a trip to the bathroom an unwelcome adventure. Two nights ago, I lay in bed awake, pillows wedged at strategic points, hoping to find some comfort, any comfort.
And then all hell broke loose. My back spasms loosened up a bit last night, so I got a few essential…