LOW BACK PAIN- THE METABOLIC DISEASE.

Corresponding Author:
Dr. Pankaj Kumar,
1348/35, St. No. 03, Rishi Nagar Extension,
Habowal Khurd, Ludhiana-141001, Punjab, India.
E-mail: drpkspsy@gmail.com

ABSTRACT

BACKGROUND

Low backache can be defined as acute or chronic ache localized to the anatomic area below the posterior ribs and above the lower margin of buttocks. Patients with complex back pain have increased risk of underlying medical conditions and need further workup. The causes of LBP can be broadly classified into mechanical, metabolic, inflammatory, neoplastic or traumatic. The present study was designed to study the metabolic factors associated with low back ache.

MATERIALS AND METHODS

This is a descriptive study done in the department of orthopedics at Dayanand Medical College &Hospital, Ludhiana, from 1/02/2014 to 1/06/2015. Patients with low back ache persisting for >6 weeks, not responding to conservative treatment, without any neurological deficit, irrespective of sex type, were included in the study. Patients below the age of 18 years, or having neoplasm were excluded from the study. Thorough history was taken from the patients and attendants. The patients underwent physical and clinical examination and investigations like TLC, ESR, Calcium, Phosphorous, Alkaline Phosphatase, Creatine, SGOT, SGPT and Vitamin D levels and X rays of the lumbosacral spine were done for every patient. Osteoporosis was graded on the X-rays according to Jikei University Classification. If required by the clinician, MRI or bone scan was done to arrive at the final diagnosis.

RESULTS

Out of the 32 patients in the study, 14 had metabolic bone disease. Mean age of the patients with metabolic bone disease was 52.9 years. Out of 14 patients with metabolic bone disease, 3 were males and 11 were females; and 9 (28.13%) showed decreased vitamin D levels in their serum. There was a significant difference in sun exposure between the patients with vitamin D deficiency and rest of the patients. Low calcium intake and hypovitaminosis D were directly related to low back pain.

CONCLUSION

This study looked into various metabolic factors contributing to low back pain in Indian population. There is high prevalence of metabolic disease in elderly females with chronic backache, which should be properly screened, and the subjects should be adequately supplemented with vitamin D and calcium.

KEY WORDS

Low Back Pain, Metabolic, Vitamin D, Calcium