Unilateral low back ache – a personal opinion

Abstract

Most backache seen in general practice is of functional cause, and sufferers never end up in Tertiary Hospitals. Their pathology cannot be demonstrated on X-Rays or contrast studies. It can be accurately diagnosed and treated in 30-50% of patients.1 An enthesiopathy of the posterior iliac crest is a very common and eminently treatable condition. Unfortunately for our patients, this diagnosis is rarely made. This article addresses those types of backache, which are left out of many texts on the subject, without detracting from the knowledge about the less common, but more serious causes usually discussed in the literature. The use of a combination of long acting steroids and bupivicaine is very useful for treatment of enthesiopathies as well as for caudal epidural blocks in patients with nerve root compression symptoms.