Abstract
lifting or a fall may initiate the trouble. Sometimes low back pain comes on gradually as a result of the continued stress caused by anomalies in the formation of the fourth and fifth lumbar vertebrae and the articulation with the sacrum. Overweight, pregnancy, or just improper use of the back will then cause trouble in this area. Finally there is the now famous slipped disk-in reality, a herniation of the nucleus pulposus or soft central portion of the intervertebral disk. This protrusion presses on the nerve roots as they exit from the spinal canal, causing the sciatic pain going down the leg which is the patient's chief complaint. How should acute low back pain be treated? Conservative therapy is always tried first: rest on a firm bed; heat to the area; frequently traction to relax the muscle spasm and to keep the patient quiet. The traction may be applied by Buck's extension, by leather anklets, or by a pelvic girdle. Almost all patients with back pain other than disk in origin improve under such a regimen. Frequently even disk symptoms are alleviated. When the acute stage is over, patients may be started on exercises to gradually strengthen their back muscles as prophylaxis against another attack. On occasion a lumbosacral corset or brace is also indicated.
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