ABSTRACT This paper is made to complete the assignment for Medical English 3 in Faculty of Medicine, Trisakti University.

In this paper, I would like to give the reader a etter

understanding a out low ack pain in men so they can prevent it. !ow ack pain is one of the most significant health pro lems. "ain in the lower ack can generate from ony lum ar spine, discs etween the verte rae, ligaments around the spine and discs, spinal cord and nerves, muscles of the low ack, internal organs of the pelvis and a domen, and the skin covering the lum ar area. "ain in the lower ack is generally called lum ar strain, and is a stretching in#ury to the ligaments, tendons, and$or muscles of the low ack, which can result in microscopic tears in these tissues. It is a soft tissue in#ury, which can occur ecause of overuse, improper use, or trauma. Keyword % !ow ack pain, men

INTRODUCTION I would like to give the reader a etter understanding a out low ack pain in men ecause !ow ack pain & or lum ago' is a common musculoskeletal disorders affecting ()* of people at some point in their life. + out two thirds of adults suffer from low ack pain at some time. +lthough the overall occurrence of ack pain similar in men and women, a greater percentage of men &,-.-*' e.perience low ack pain than women &/-.0*'. I hope this paper can reduce the incidence of low ack pain. The reader can prevent it and not cause disadvantage. !ow ack pain can cause deformity and lost of #o in +merican. 1eventy to (/ percent of all people have ack pain at some time in their life. !ow ack pain can range from mild, dull, annoying pain, to persistent, severe, disa ling pain in the lower ack. "ain in the lower ack can restrict mo ility and interfere with normal functioning. Many things can cause low ack in#uries like muscle strain or spasm, sprains of ligaments &which attach one to one', #oint pro lems or a 2slipped disk3. The association etween symptoms and imaging results is weak. The treatment very much depends on the precise cause of the low ack pain. Moreover, each patient must e individually evaluated and managed in the conte.t of the underlying ackground health status and activity level. &-'

LOW BACK PAIN Definition !ow ack pain is when you feel sore or uncomforta le in your lower ack or uttocks. It is usually caused y muscle strain in your lower ack. If you strain a muscle in your ack, it can hurt to move it. &-' Frequency 4early everyone has low ack pain sometime. Men and women are e5ually affected. It occurs most often etween ages 3) and /). +lthough the overall occurrence of ack pain similar in men and women, a greater percentage of men &,-.-*' e.perience low ack pain than women &/-.0*', while more women &6.,*' suffer from upper ack pain than men &,.,*'.&0' Ris F!ctors 7isk factors include heavy lifting and twisting, odily vi ration, o esity, and poor

conditioning, although low ack pain is common even in people without these risk factors. &0' C!uses The following are the causes of low ack pain&3,8'

In#ury or overuse of muscles, ligaments, facet #oints, and the sacroiliac #oints. "ressure on nerve roots in the spinal canal. 4erve root compression can e caused y%
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+ herniated disc, often rought on y repeated vi ration or motion &as during machine use or sport activity, or when lifting improperly', or y a sudden heavy strain or increased pressure to the lower ack.
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9steoarthritis &#oint degeneration', which typically develops with age. :hen osteoarthritis affects the small facet #oints in the spine, it can lead to ack pain. 9steoarthritis in other #oints, such as the hips, can cause you to limp or to change the way you walk. This can also lead to ack pain.

1pondylolysis and spondylolisthesis, verte ra defects that can allow a verte ra to slide over another when aggravated y certain activities.

1pinal stenosis, or narrowing of the spinal canal, which typically develops with age.

Fractures of the verte rae caused y significant force, such as from an auto or icycle accident, a direct low to the spine, or compressing the spine y falling onto the uttocks or head.

1pinal deformities, including curvature pro lems such as severe scoliosis or kyphosis.

;ompression fractures. ;ompression fractures are more common among postmenopausal women with osteoporosis, or in men or women after long<term corticosteroid use. In a person with osteoporosis, even a small amount of force put on the spine, as from a snee=e, may cause a compression fracture.

+nkylosing spondylitis, which is a form of #oint inflammation &arthritis' that most often affects the spine.

>acterial infection. >acteria are usually carried to the spine through the loodstream from an infection somewhere else in the ody or from I? drug use. >ut acteria can enter the
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spine directly during surgery or in#ection treatments, or as the result of in#ury. >ack pain may e the result of an infection in the one &osteomyelitis', in the spinal discs, or in the spinal cord.

1pinal tumors, or growths that develop on the ones and ligaments of the spine, on the spinal cord, or on nerve roots.

"edic!# $istory ;lues to underlying systemic disease include the patient@s ageA a history of cancer, une.plained weight loss, in#ection<drug use, or chronic infectionA the duration of painA the presence of nighttime painA and the response to previous therapy. In many patients whose low ack pain is due to infection or cancer, the pain is not relieved when the patient lies down. Bowever, this finding is not specific for the presence of these conditions. &/'

P%ysic!# &'!(in!tion The physician will e.amine the ack and conduct neurologic tests to determine the cause of pain. The remainder of the neurologic e.amination should focus on ankle and great<toe dorsifle.ion strength &the !/ nerve root', plantar fle.ion strength &1-', ankle and knee refle.es &1- and !8', and dermatomal sensory loss. The !/ and 1- nerve roots are involved in appro.imately 6/ percent of lum ar<disk herniations. 1ymptom like fever suggests the possi ility of spinal infection. ?erte ral tenderness has sensitivity for infection ut not

specificity. ;hest e.pansion of less than 0./ cm has specificity, ut not sensitivity, for ankylosing spondylitis. &/' Wor u) In addition to a complete medical history and physical e.amination, diagnostic procedures for low ack pain may include the following. Bowever, during many initial

assessments and e.aminations, speciali=ed tests are not necessary. &,'

C<ray < a diagnostic test which uses invisi le electromagnetic energy eams to produce images of internal tissues, ones, and organs onto film.

;omputed tomography scan &+lso called a ;T or ;+T scan.' < a diagnostic imaging procedure that uses a com ination of .<rays and computer technology to produce cross< sectional images &often called slices', oth hori=ontally and vertically, of the ody. + ;T scan shows detailed images of any part of the ody, including the ones, muscles, fat, and organs. ;T scans are more detailed than general .<rays.

Magnetic resonance imaging &M7I' < a diagnostic procedure that uses a com ination of large magnets, radiofre5uencies, and a computer to produce detailed images of organs and structures within the ody.

7adionuclide one scan < a nuclear imaging techni5ue that uses a very small amount of radioactive material, which is in#ected into the patient@s loodstream to e detected y a scanner. This test shows lood flow to the one and cell activity within the one.

Electromyogram &EMD' < a test to evaluate nerve and muscle function.

Classification 9ne method of classifying lower ack pain is y the duration of symptoms% acute &less than , weeks' su acute &,E-0 weeks' chronic &greater than -0 weeks'

Tre!t(ent Most low ack pain can e treated without surgery. Treatment involves using analgesics, reducing inflammation, restoring proper function and strength to the ack, and preventing

recurrence of the in#ury. Most patients with ack pain recover without residual functional loss. "atients should contact a doctor if there is not a noticea le reduction in pain and inflammation after F0 hours of self<care. &F'

;ompresses may help reduce pain and inflammation and allow greater mo ility for some individuals.

>ed rest G -E0 days at most. "atients should resume activities as soon as possi le. +t night or during rest, patients should lie on one side, with a pillow etween the knees &some doctors suggest resting on the ack and putting a pillow eneath the knees'.

Medications including nonsteroidal anti<inflammatory drugs &aspirin, napro.en, and i uprofen', +nticonvulsants , 1ome antidepressants, 9pioids.

In the most serious cases, when the condition does not respond to other therapies, surgery may relieve pain caused y ack pro lems or serious musculoskeletal in#uries. E.amples Hiscectomy, Foraminotomy, IntraHiscal Electrothermal Therapy &IHET', 4ucleoplasty.

E.ercise may e the most effective way to speed recovery from low ack pain and help strengthen ack and a dominal muscles.

Low *!c )!in re%!*i#it!tion+ Denerally, there are three phases to low ack pain reha ilitation. &F' "hase I% +cute "hase

Huring this initial phase, the physiatrist and treatment team focus on making a diagnosis, developing a treatment plan, and starting treatment to reduce the pain and inflammation. This may include some of the items listed a ove and possi ly the utili=ation of ultrasound, electrical stimulation, or special in#ections. "hase II% 7ecovery "hase
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9nce the initial pain and inflammation are reduced, the reha ilitation team then focuses on helping the patient restore function. This includes returning the patient to normal daily activities, while starting an e.ercise program that is designed to help the patient regain fle.i ility and strength. "hase III% Maintenance "hase

The goal of this phase is two<fold% educating the patient on ways to prevent further in#ury and strain to the ack and neck, and helping the patient to prevent further in#ury y improving strength and endurance.

Pre,ention&F' E.ercise programs that com ine aero ic conditioning with specific strengthening of the ack and legs can reduce the fre5uency of recurrence of low ack pain. The use of corsets and education a out lifting techni5ue are generally ineffective in preventing low ack pro lems. Epidemiologic studies suggest that weight loss and smoking cessation may have preventive value, ut no intervention trials involving these approaches have een conducted. There are, of course, other compelling reasons to recommend weight loss and smoking cessation. Ergonomic redesign of strenuous #o tasks may facilitate return to work and reduce the chronic nature of pain. An!to(y of t%e Lower B!c
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It is a comple. structure of verte rae, disks, spinal cord, and nerves, and includes five ones, called lum ar verte rae, stacked one upon the other that connect the upper spine to the pelvis si. shock a sor ers, called disks, which act oth as cushions and sta ili=ers to protect the lum ar verte rae

The spine has four regions% <The seven cervical or neck verte rae &la eled ;-E;F', <The -0 thoracic or upper ack verte rae &la eled T-ET-0', <The five lum ar verte rae &la eled !-E!/', which we know as the lower ack <The sacrum and coccy., a group of ones fused together at the ase of the spine.

The lum ar region of the ack, where most ack pain is felt, supports the weight of the upper ody.

Functions of t%e Lower B!c "rotects the soft tissues of the nervous system and spinal cord, as well as ad#acent organs of the pelvis and a domen.
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:hen standing, the lower ack holds most of the weight of the ody. :hen ending, e.tending or rotating at the waist the lower ack is involved in the movement.

CONCLUSION !ow ack pain is one of the most significant health pro lems. . Men and women are e5ually affected. It occurs most often etween ages 3) and /). +lthough the overall occurrence of ack pain similar in men and women, a greater percentage of men e.perience low ack pain than women. 7apid return to normal activities is usually the est course. >ack e.ercises are not useful for the acute phase ut help to prevent recurrences and treat chronic pain. 1urgery is appropriate for a small proportion of patients with low ack symptoms.

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R&F&R&NC&S -. University of Maryland Medical ;entre. !iterature reviews. +vaila le at % http%$$www. umm.edu. +ccessed Hecem er -0, 0))6.

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0. Rodts M. !ow >ack pain getting to the root of the pro lem. +vaila le at % http%$$www. spineuniverse.com$ ack<pain$condition<centre. +ccessed Hecem er --, 0))6.
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http%$$www.we md.com$hw<popup$low< ack<pain. +ccessed Hecem er -0, 0))6. 8. 1alter 7 >. Te.t ook of Hisorders and In#uries of The 1keletal 1ystem % Hegenerative Hisorders of Ioints and 7elated Tissue. 3rd ed. U1+% !ippincott :illiams J :ilkins A -666A p.0().
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http%$$www.content.ne#m$content$vol388$issue/$inde..dtl. +ccessed Hecem er -), 0))6. ,. 4ational Institute of 4eurological Hisorders and 1troke. !iterature reviews. +vaila le +t % http%$$www. ninds.nih.gov. +ccessed Hecem er --, 0))6. F. +merican +cademy of Family "hysicians. !iterature reviews. +vaila le at % http%$$www.familydoctor.org$online$famdocen$home$men.html. Hecem er 6, 0))6. (. University of ?irginia Bealth 1ystem. !iterature reviews. +vaila le at % http%$$www.healthsystem.virginia.edu$toplevel$home$home.cfm. Hecem er -0, 0))6. +ccessed +ccessed

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