Management of Back Pain

Part 1 Introduction: upright man; back pain - a problem - personal, national and clinical; the causes of back pain - aetiology. Part 2 Basic science: structures that fail; the nociceptve source; the significance of the vertebral canal - compromise of its contents and its development; structures that restrain shear - and their failure; pain perception and behaviour. Part 3 Clinical assessment and investigation of back pain: the consultation; radiological investigation of patients with back pain; magnetic resonance imaging (MRI) in the investigation of patients with back pain; radionuclide bone scanning in back pain management; ultrasound in spinal investigation; diagnostic pain provocation. Part 4 Diagnosis and management: herniated nucleus pulposus - pathology, diagnosis and management; root entrapment syndrome from lateral canal stenosis - pathology, presentation and management; neurogenic claudication - its clinical presentation, differential diagnosis, pathology and management; spinal segmental instability - biomechanical definition, symptoms, signs, radiological features and management; lysis of the pars interarticularis - pathology, identification of the defect, clinical significance and management; unilateral spondylolysis - pathology, symptoms and management; retrolisthesis and degenerative lumbar scoliosis - pathology, clinical significance and treatment; fractures of the vertebrae - spinal injury, pathology, symptoms, management and natural history - and osteoporotic fractures; spinal fusion - indications and methods; soft tissue injury; conservative management; the elderly spine. Part 5 The problem back patient: repeat spinal surgery; back pain - an exhibition of distress. Part 6 Prevention: prevention of back pain.