Low Back Pain: A Pain That May Not Be Harmless

Lucas, Catarina; Costa, Joana; Paixão, Joana; Silva, Fátima; Ribeiro, Pedro Moutinho; Rodrigues, Adriano

doi:10.12890/2018_000834

Cited by 3 publications

(2 citation statements)

References 1 publication

Supporting

Mentioning

Contrasting

Order By: Relevance

“… 5 Patients with chronically contained rupture of aneurysms are hemodynamically stable and have a long history of back or loin pain with symptoms attributable to compressive or erosive effect. 6 In fact, as in this case, the rupture may occur within a contained space such as the retroperitoneum or the psoas muscle space, leading to the patient being stable at presentation and often for longer. 5 Booth and Galland 7 reported that the clinical features of contained AAA rupture are vague with back pain in 64% of cases, abdominal pain in 20%, groin pain in 14%, femoral neuropathy in 8%, sepsis in 10%, and asymptomatic in 8%.…”

Section: Discussionmentioning

confidence: 84%

Chronic abdominal aortic rupture mimicking femoral neuropathy

Modugno

Salman

Picone

et al. 2022

SAGE Open Medical Case Reports

View full text Add to dashboard Cite

Chronic-contained rupture of an aortic aneurysm is a rare subset of ruptured aneurysms. The presentation is unusual, and the diagnosis is frequently delayed. Here, we describe a case of contained rupture of abdominal aortic aneurysm that presented with signs and symptoms of femoral neuropathy. Clinical and radiological findings were initially misinterpreted. The correct diagnosis was formulated belatedly, causing a progressively increased risk of fatal events. Surgical aortic repair was performed and the postoperative course was uneventful. In conclusion, in the presence of a retroperitoneal mass, a diagnosis of chronic-contained rupture of an abdominal aortic aneurysm should be considered.

show abstract

Section: Discussionmentioning

confidence: 84%

Chronic abdominal aortic rupture mimicking femoral neuropathy

Modugno

Salman

Picone

et al. 2022

SAGE Open Medical Case Reports

View full text Add to dashboard Cite

show abstract

“…Multiple case reports have also reported severe LBP in patients with abdominal aortic aneurysms and state this as an often-overlooked differential diagnosis. 5,11,22,31 Similarly, 1 study showed improved LBP after surgical treatment of abdominal aortic aneurysms in patients with high aortic occlusion, and they concluded an ischemic component of LBP in those patients. 30 Although some studies report an association between AAC and severity of disk degeneration, we did not find any differences.…”

Section: Discussionmentioning

confidence: 99%

Association of abdominal aortic calcification and lower back pain in patients with degenerative spondylolisthesis

Schönnagel,

Muellner,

Suwalski

et al. 2023

Pain

View full text Add to dashboard Cite

Abdominal aortic calcification (AAC) is hypothesized to lead to ischemic pain of the lower back. This retrospective study aims to identify the relationship between AAC and lower back pain (LBP) in patients with degenerative lumbar spondylolisthesis. Lower back pain was assessed preoperatively and 2 years after surgery using the numeric analogue scale. Abdominal aortic calcification was assessed according to the Kauppila classification and was grouped into no, moderate, and severe. A multivariable regression, adjusted for age, sex, body mass index, hypertension, and smoking status, was used to assess the association between AAC and preoperative/postoperative LBP as well as change in LBP after surgery. A total of 262 patients were included in the final analysis. The multivariable logistic regression demonstrated an increased odds ratio (OR) for preoperative LBP ≥ 4 numeric analogue scale (OR = 9.49, 95% confidence interval [CI]: 2.71-40.59, P < 0.001) and postoperative LBP ≥ 4 (OR = 1.72, 95% CI: 0.92-3.21, P = 0.008) in patients with severe AAC compared with patients with no AAC. Both moderate and severe AAC were associated with reduced improvement in LBP after surgery (moderate AAC: OR = 0.44, 95% CI: 0.22-0.85, P = 0.016; severe AAC: OR = 0.41, 95% CI: 0.2-0.82, P = 0.012). This study demonstrates an independent association between AAC and LBP and reduced improvement after surgery. Evaluation of AAC could play a role in patient education and might be considered part of the differential diagnosis for LBP, although further prospective studies are needed.

show abstract

Extravertebral low back pain: a scoping review

Kunow,

Freyer Martins Pereira,

Chenot

2024

BMC Musculoskelet Disord

View full text Add to dashboard Cite

Background Low back pain (LBP) is one of the most common reasons for consultation in general practice. Currently, LBP is categorised into specific and non-specific causes. However, extravertebral causes, such as abdominal aortic aneurysm or pancreatitis, are not being considered. Methods A systematic literature search was performed across MEDLINE, Embase, and the Cochrane library, complemented by a handsearch. Studies conducted between 1 January 2001 and 31 December 2020, where LBP was the main symptom, were included. Results The literature search identified 6040 studies, from which duplicates were removed, leaving 4105 studies for title and abstract screening. Subsequently, 265 publications were selected for inclusion, with an additional 197 publications identified through the handsearch. The majority of the studies were case reports and case series, predominantly originating from specialised care settings. A clear distinction between vertebral or rare causes of LBP was not always possible. A range of diseases were identified as potential extravertebral causes of LBP, encompassing gynaecological, urological, vascular, systemic, and gastrointestinal diseases. Notably, guidelines exhibited inconsistencies in addressing extravertebral causes. Discussion Prior to this review, there has been no systematic investigation into extravertebral causes of LBP. Although these causes are rare, the absence of robust and reliable epidemiological data hinders a comprehensive understanding, as well as the lack of standardised protocols, which contributes to a lack of accurate description of indicative symptoms. While there are certain disease-specific characteristics, such as non-mechanical or cyclical LBP, and atypical accompanying symptoms like fever, abdominal pain, or leg swelling, that may suggest extravertebral causes, it is important to recognise that these features are not universally present in every patient. Conclusion The differential diagnosis of extravertebral LBP is extensive with relatively low prevalence rates dependent on the clinical setting. Clinicians should maintain a high index of suspicion for extravertebral aetiologies, especially in patients presenting with atypical accompanying symptoms.

show abstract

Low Back Pain: A Pain That May Not Be Harmless

Cited by 3 publications

References 1 publication

Chronic abdominal aortic rupture mimicking femoral neuropathy

Chronic abdominal aortic rupture mimicking femoral neuropathy

Association of abdominal aortic calcification and lower back pain in patients with degenerative spondylolisthesis

Extravertebral low back pain: a scoping review

Contact Info

Product

Resources

About