Evaluation of Patients With Low Back Pain

Öz

One of the most common complaints in clinics is low back pain. These pain is usually caused by mechanical disorders. The aim of this study is to determine the prevalence of patients with low back pain and to evaluate the distribution and treatment of mechanical / inflammatory back pain. Patients who applied to our outpatient clinic with low back pain between Ocak 2016-Aralık 2017 were screened retrospectively. The demographic and clinical information of the patients were obtained from the file records. In our polyclinic, 1398 (7.5%) patients presented with low back pain. Inflamatuar back pain was seen 67 (4.79%) of the patients and mechanical back pain was seen 1331 (95.27%) of the patients. The mean age of the mechanical back pain patients was 50.2 ± 16.09 and 41.8 ± 11.1 of the inflammatory back pain patients. All the patients who presented to polyclinic, 841 (60.1%) were female and 557 (39.8%) were male. Patients who had mechanical back pain, 829 (62.3%) were female and 502 (37.7%) were male; patients who had inflamatuar back pain, 12 (17.9%) were female and 55 (82.1%) were male .Acute / subacute and chronic low back pain rates respectevely 136 (10.2%) and 1195 (89.9%). Because of the neuropathic pain presence, 138 (10.4%) of the patients were receiving pregabalin /gabapentin treatment. Low back pain is common in the community. Although acute low back pain is more common, tertiary health care institutions mostly are got application by patients with chronic low back pain. Low back pain causes loss of  life quality and labor. Therefore, it was concluded that differential diagnosis, planning of treatment and taking protective measures are important.

Anahtar Kelimeler

• low back pain

Bel Ağrılı Hastalarımızın Değerlendirilmesi

Öz

Bel ağrısı toplumda en sık poliklinik başvuru nedenlerinden birisidir. Bel ağrılarının büyük kısmını mekanik bel ağrıları oluşturur. Çalışmamızın amacı; kliniğimize bel ağrısı nedeniyle başvuran hastaların sıklığının, mekanik/inflamatuvar bel ağrısı yönünden dağılımının ve tedavi yaklaşımının değerlendirilmesidir. Polikliniğimize 2016-2017 yılları arasında bel ağrısı nedeniyle başvuran hastalar geriye dönük tarandı. Hastaların demografik ve klinik bilgileri dosya kayıtlarından elde edildi. Polikliniğimize 1398 (%7.5) hastanın bel ağrısı nedeniyle başvurduğu, hastaların 67 (%4.79)’sinde inflamatuvar bel ağrısı, 1331 (%95.27)’inde mekanik bel ağrısı olduğu saptandı. Hastaların yaş ortalaması mekanik bel ağrısı grubunda 50.2 ± 16.09, inflamatuvar bel ağrısı grubunda 41.8 ± 11.1’di. Hastaların 841(%60.1)’i kadın, 557 (%39.8)’si erkekti. Mekanik bel ağrısı olanların 829 (%62.3)’u kadın ve 502 (%37.7)’si erkek, inflamatuvar bel ağrısı olanların 12 (%17.9)’si kadın ve 55 (%82.1)’ü erkekti. Hastaların 136 (%10.2)’sı akut/subakut,  1195 (%89,9)’i kronik bel ağrısına sahipti. Nöropatik ağrı varlığı nedeniyle hastaların 138 (%10.4)’i tedavi alıyordu. Bel ağrıları toplumda sık görülür. Bel ağrısı nedenlerinin büyük kısmını mekanik bel ağrıları oluşturur. Üçüncü basamak sağlık kuruluşlarına kronik bel ağrılı hastalar daha fazla başvurur. Bel ağrısı yaşam kalitesi ve iş gücü kaybına neden olur. Bu nedenle ayrıcı tanısının yapılması, tedavisinin planlanmasının ve koruyucu önlemlerinin alınmasının önemli olduğu sonucuna varılmıştır.

Anahtar Kelimeler

• bel ağrısı,sıklık

Kaynakça

1. KAYNAKLAR
2. 1. Gilgil, E., et al., Prevalence of low back pain in a developing urban setting. 2005. 30(9): p. 1093-1098.
3. 2. Skovron, M., et al., Sociocultural factors and back pain. A population-based study in Belgian adults. 1994. 19(2): p. 129-137.
4. 3. Hartvigsen, J., et al., What low back pain is and why we need to pay attention. 2018. 391(10137): p. 2356-2367.
5. 4. Icagasioglu, A., et al., Burden of chronic low back pain in the Turkish population/Kronik bel agrisinin turk toplumuna maliyeti. 2015. 61(1): p. 58-65.
6. 5. Kim, N., et al., An economic analysis of usual care and acupuncture collaborative treatment on chronic low back pain: a Markov model decision analysis. 2010. 10(1): p. 74.
7. 6. Oksuz, E.J.S., Prevalence, risk factors, and preference-based health states of low back pain in a Turkish population. 2006. 31(25): p. E968-E972.
8. 7. TAFLAN, H. and E.J.T.K.J.o.P.M.R.S.T. ÇAPKIN, Kronik Bel Ağrısı. 2017. 10(3): p. 275-282.

9. 8. IN, B., Hochberg MC, Silman AJ, Smolen JS, Weinblatt ME, Weisman MH. Rheumatology, in Lumbar spine disorders. 2008, Philadelphia: Elsevier. p. 593-618. .
10. 9. Rudwaleit, M., Muhammad A. Khan, and Joachim Sieper. , "The challenge of diagnosis and classification in early ankylosing spondylitis: do we need new criteria?.". Arthritis & Rheumatism 2005. 52(4): p. 1000-1008.
11. 10. Walker, B.F., "The prevalence of low back pain: a systematic review of the literature from 1966 to 1998.". Clinical Spine Surgery 2000. 13(3): p. 205-217.
12. 11. Ketenci, A., Yıldız, E., Müslümanoğlu, L., Arıkan, E., Durmuş, B., & Filiz, M. , Kronik mekanik bel ağrılı 1120 hastanın özellikleri. Türk Fiz Tıp Rehab Derg, 1998. 1: p. 60-4.
13. 12. Devereux, J.J., Peter W. Buckle, and Ioannis G. Vlachonikolis., "Interactions between physical and psychosocial risk factors at work increase the risk of back disorders: an epidemiological approach.". Occupational and Environmental Medicine 1999. 56(5): p. 343-353.
14. 13. Biering-Sørensen, F.I.N., Physical measurements as risk indicators for low-back trouble over a one-year period. Spine,, 1984. 9(2): p. 106-119.
15. 14. Andersson, G.B.J., Svensson, H. O., & OdÉn, A. , The intensity of work recovery in low back pain. Spine,, 1983. 8(8): p. 880-884.
16. 15. Pengel, L.H., Herbert, R. D., Maher, C. G., & Refshauge, K. M. , Acute low back pain: systematic review of its prognosis. Bmj, 2003. 327(7410),: p. 323.
17. 16. Anderson GBJ, S.H., Odén A. , Epidemiologic study of episodes of back pain care. Spine, 1995. 20(15): p. 1668-73.
18. 17. Chou, R., Qaseem, A., Snow, V., Casey, D., Cross, J. T., Shekelle, P., & Owens, D. K. , Diagnosis and treatment of low back pain: a joint clinical practice guideline from the American College of Physicians and the American Pain Society. Annals of internal medicine, 2007. 147(7): p. 478-491.
19. 18. Gudala, K., Bansal, D., Vatte, R., Ghai, B., Schifano, F., & Boya, C. , High Prevalence of Neuropathic Pain Component in Patients with Low Back Pain. Evidence from Meta-Analysis, 2017: p. 343-352.
20. 19. Doualla, M., Luma, H. N., Tchaleu, B. N., Kwedi, F., Kemta, F. L., Memopi, M., & Ngandeu, M. S. , The neuropathic component of chronic low back pain in Douala-Cameroon. In CLINICAL RHEUMATOLOGY, 2013. 32: p. 123-124.
21. 20. Uher, T., & Bob, P., Neuropathic pain, depressive symptoms, and C-reactive protein in sciatica patients. International Journal of Neuroscience, 2013. 123(3): p. 204-208.
22. 21. Enke, O., New, H. A., New, C. H., Mathieson, S., McLachlan, A. J., Latimer, J., ... & Lin, C. W. C. , Anticonvulsants in the treatment of low back pain and lumbar radicular pain: a systematic review and meta-analysis. CMAJ, 2018. 190(26): p. E786-E793.
23. 22. Skaf, G., Bouclaous, C., Alaraj, A., & Chamoun, R., Clinical outcome of surgical treatment of failed back surgery syndrome. Surgical neurology, 2005. 64(6): p. 483-488.
24. 23. Mekhail, N., Wentzel, D. L., Freeman, R., & Quadri, H. , Counting the costs: case management implications of spinal cord stimulation treatment for failed back surgery syndrome. Professional case management, 2011. 16(1): p. 27-36.