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{{Back pain}}
{{Back pain}}


{{CMG}}; {{AE}} {{Fs}}
{{CMG}}; {{AE}} {{ZMalik}} {{Fs}}
==Overview==
==Overview==
There is no established system for the classification of [disease name].
On the basis of origin, [[back]] [[pain]] can be broadly classified into three categories: [[axial]], [[referred]], and radicular. [[Back]] [[pain]] can also be classified on the basis of its underlying [[etiology]] into mechanical and non-mechanical.
 
OR
 
[Disease name] may be classified according to [classification method] into [number] subtypes/groups: [group1], [group2], [group3], and [group4].
 
OR
 
[Disease name] may be classified into [large number > 6] subtypes based on [classification method 1], [classification method 2], and [classification method 3].
[Disease name] may be classified into several subtypes based on [classification method 1], [classification method 2], and [classification method 3].
 
OR
 
Based on the duration of symptoms, [disease name] may be classified as either acute or chronic.
 
OR
 
If the staging system involves specific and characteristic findings and features:
According to the [staging system + reference], there are [number] stages of [malignancy name] based on the [finding1], [finding2], and [finding3]. Each stage is assigned a [letter/number1] and a [letter/number2] that designate the [feature1] and [feature2].
 
OR
 
The staging of [malignancy name] is based on the [staging system].
 
OR
 
There is no established system for the staging of [malignancy name].


==Classification==
==Classification==
*[[Back]] [[pain]] can be classified into three broad categories on the basis of its origin including [[axial]], referred and radicular:<ref name="pmid30854609">{{cite journal| author=Urits I, Burshtein A, Sharma M, Testa L, Gold PA, Orhurhu V | display-authors=etal| title=Low Back Pain, a Comprehensive Review: Pathophysiology, Diagnosis, and Treatment. | journal=Curr Pain Headache Rep | year= 2019 | volume= 23 | issue= 3 | pages= 23 | pmid=30854609 | doi=10.1007/s11916-019-0757-1 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30854609  }} </ref>
{| class="wikitable"
|'''Origin'''||'''Distinguishing Feature'''
|-
|[[Axial]] [[Pain]]|| Mechanical [[pain]] limited to one region. Could be sharp, dull, intermittent, throbbing, constant.
|-
|Referred [[Pain]]||Dull/achy [[pain]] that moves around and varies in intensity.
|-
|Radicular [[pain]]||Follows a [[spinal nerve]] pathway, mostly described as [[sensation]] of [[numbness]], [[tingling]], [[weakness]].
|}
*[[Back]] [[pain]] can also be classified on the basis of its underlying [[etiology]] into mechanical and non-mechanical:<ref name="pmid24150427">{{cite journal |vauthors=Sun JC, Xu T, Chen KF, Qian W, Liu K, Shi JG, Yuan W, Jia LS |title=Assessment of cauda equina syndrome progression pattern to improve diagnosis |journal=Spine (Phila Pa 1976) |volume=39 |issue=7 |pages=596–602 |date=April 2014 |pmid=24150427 |doi=10.1097/BRS.0000000000000079 |url=}}</ref><ref name="pmid2967893">{{cite journal |vauthors=Deyo RA, Diehl AK |title=Cancer as a cause of back pain: frequency, clinical presentation, and diagnostic strategies |journal=J Gen Intern Med |volume=3 |issue=3 |pages=230–8 |date=1988 |pmid=2967893 |doi=10.1007/BF02596337 |url=}}</ref><ref name="pmid7987418">{{cite journal |vauthors= |title=Acute low back problems in adults: assessment and treatment. Agency for Health Care Policy and Research |journal=Clin Pract Guidel Quick Ref Guide Clin |volume= |issue=14 |pages=iii–iv, 1–25 |date=December 1994 |pmid=7987418 |doi= |url=}}</ref><ref name="pmid8542211">{{cite journal |vauthors=Underwood MR, Dawes P |title=Inflammatory back pain in primary care |journal=Br J Rheumatol |volume=34 |issue=11 |pages=1074–7 |date=November 1995 |pmid=8542211 |doi=10.1093/rheumatology/34.11.1074 |url=}}</ref><ref name="pmid19101212">{{cite journal |vauthors=Szadek KM, van der Wurff P, van Tulder MW, Zuurmond WW, Perez RS |title=Diagnostic validity of criteria for sacroiliac joint pain: a systematic review |journal=J Pain |volume=10 |issue=4 |pages=354–68 |date=April 2009 |pmid=19101212 |doi=10.1016/j.jpain.2008.09.014 |url=}}</ref> 


Back pain may be classified according to etiology into 2 groups:  
{| class="wikitable"
 
|'''Etiology'''||'''Diseases'''
* Mechanical
  |-
**Cauda equina syndrome
|Mechanical|| [[Cauda equina syndrome]], [[vertebral]] [[compression fracture]], [[radiculopathy]], [[spinal stenosis]], [[ankylosing spondylitis]], [[osteoarthritis]], [[scoliosis]], [[piriformis syndrome]], [[sacroiliac]] [[joint]] [[dysfunction]], [[lumbar strain]], [[herniated disc]]
**Vertebral compression fracture
|-
**Radiculopathy
|Non-mechanical||[[Multiple myeloma]] , [[retroperitoneal]] [[tumors]], [[psoriatic]] [[spondylitis]], [[reactive arthritis]], [[inflammatory bowel disease]], [[endometriosis]], [[chronic]] [[pelvic inflammatory disease]], [[pancreatitis]], [[cholecystitis]], [[nephrolithiasis]], [[pyelonephritis]], [[abdominal aortic aneurysm]], [[herpes zoster]], [[metastatic]] [[cancer]], [[spinal epidural abscess]], [[vertebral]] [[osteomyelitis]]
**Spinal stenosis
|}
**Ankylosing spondylitis
**Osteoarthritis
**Scoliosis and hyperkyphosis
**Piriformis syndrome
**Sacroiliac joint dysfunction
**Lumbar strain
**Herniated disk
* Non-mechanical
** Multiple myeloma
** Retroperitoneal tumors
** Psoriatic spondylitis
** Reactive arthritis
** Inflammatory bowel disease
** Endometriosis
** Chronic pelvic inflammatory disease
**Pancreatitis
**Cholecystitis
**Nephrolithiasis
**Pyelonephritis
**Abdominal aortic aneurysm
**Herpes zoster
**Psychologic distress
**Metastatic cancer
**Spinal epidural abscess
**Vertebral osteomyelitis


==References==
==References==

Latest revision as of 15:05, 1 April 2021

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Zehra Malik, M.B.B.S[2] Fahimeh Shojaei, M.D.

Overview

On the basis of origin, back pain can be broadly classified into three categories: axial, referred, and radicular. Back pain can also be classified on the basis of its underlying etiology into mechanical and non-mechanical.

Classification

  • Back pain can be classified into three broad categories on the basis of its origin including axial, referred and radicular:[1]
Origin Distinguishing Feature
Axial Pain Mechanical pain limited to one region. Could be sharp, dull, intermittent, throbbing, constant.
Referred Pain Dull/achy pain that moves around and varies in intensity.
Radicular pain Follows a spinal nerve pathway, mostly described as sensation of numbness, tingling, weakness.
Etiology Diseases
Mechanical Cauda equina syndrome, vertebral compression fracture, radiculopathy, spinal stenosis, ankylosing spondylitis, osteoarthritis, scoliosis, piriformis syndrome, sacroiliac joint dysfunction, lumbar strain, herniated disc
Non-mechanical Multiple myeloma , retroperitoneal tumors, psoriatic spondylitis, reactive arthritis, inflammatory bowel disease, endometriosis, chronic pelvic inflammatory disease, pancreatitis, cholecystitis, nephrolithiasis, pyelonephritis, abdominal aortic aneurysm, herpes zoster, metastatic cancer, spinal epidural abscess, vertebral osteomyelitis

References

  1. ↑ Urits I, Burshtein A, Sharma M, Testa L, Gold PA, Orhurhu V; et al. (2019). "Low Back Pain, a Comprehensive Review: Pathophysiology, Diagnosis, and Treatment". Curr Pain Headache Rep. 23 (3): 23. doi:10.1007/s11916-019-0757-1. PMID 30854609.
  2. ↑ Sun JC, Xu T, Chen KF, Qian W, Liu K, Shi JG, Yuan W, Jia LS (April 2014). "Assessment of cauda equina syndrome progression pattern to improve diagnosis". Spine (Phila Pa 1976). 39 (7): 596–602. doi:10.1097/BRS.0000000000000079. PMID 24150427.
  3. ↑ Deyo RA, Diehl AK (1988). "Cancer as a cause of back pain: frequency, clinical presentation, and diagnostic strategies". J Gen Intern Med. 3 (3): 230–8. doi:10.1007/BF02596337. PMID 2967893.
  4. ↑ "Acute low back problems in adults: assessment and treatment. Agency for Health Care Policy and Research". Clin Pract Guidel Quick Ref Guide Clin (14): iii–iv, 1–25. December 1994. PMID 7987418.
  5. ↑ Underwood MR, Dawes P (November 1995). "Inflammatory back pain in primary care". Br J Rheumatol. 34 (11): 1074–7. doi:10.1093/rheumatology/34.11.1074. PMID 8542211.
  6. ↑ Szadek KM, van der Wurff P, van Tulder MW, Zuurmond WW, Perez RS (April 2009). "Diagnostic validity of criteria for sacroiliac joint pain: a systematic review". J Pain. 10 (4): 354–68. doi:10.1016/j.jpain.2008.09.014. PMID 19101212.

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