27/f pain in bilateral lumbar para spinal muscles. On and off pain since 7 years. No history of fall. Underweight. 37 kg weight. Pain in ribs too but occasional. Diagnose and management plz

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scolios plus osteophytes at L1 to L5.. sacralisation... needs MRI... may be spondylysis with radiculopathy... if so needs pregablin 75mg sr with mecobolmine 1000mg 1 hs Etoricoxib 60mg plus thiocolchiciside 4mg 1od vitd3 60000 unit weekly for 6 weeks... calcium suppliments...

No radiculopathy
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No bony changes are seen except mild osteopenia Bad posture Sight scoliotic changes are due muscular spasm. Postural pain Advised physiotherapy. Vitamin D 3 and calcium suppliments

First prefr pain relief by swd and positional release technique then corectn of scoliosis by cat n camel ex, if pain persists then go for myofascial release with ift 4p90,base-80 swp-100 , 1/ 1....mode......... then last strengthening of all anti gravity muscles....

Actually this is change curve and paraspunal muscle severe spasm by deficient or more activity.because under wt.no muscle bulk there for support of spine so all wt wearing by spine so again agin like this.and also no suply to nucleus. Pulposus only take nutition by end plates do less activity is consequence dehydrated disk so pain .in this condition use ultrasound .after that later give short wave diathermy and aquetic therapy all movement under water and mobilization techinque massage .all the sure recover.i done before

On and off pain non radiating in young patient can b positional or occupational. Rule out for long sitting job or travelling distance , driving everyday. Time of pain morning or night...aggravating factors.Can b managed with strengthening exercises.Also to rule out sr calcium vit D3 B12 deficiencies..

She is home maker, house hold work is a routine, pain constant, deficiency reports u suggested already sent waiting for results
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Low wt pt investgate for anaemia thyroid profile serum calcium d b12 there will be spinal muscle hypotonia you have to manage with these findings when xray ls spine is normal

Mild scoliosis. Which is common seen in younger age group . Due to scoliotic changes might she had referred pain in ribs area too. Kindly go for physiotherapy. -para spinal stretch in standing position with lateral bending wall supported hip. - back core exercises -static back Static abs -isometric of adductors & glutei in crook lying position. - bridging -pelvic rotation with 15-20 rep. Which is more helpful in pain. -cat & camel exercise Progression in super man position in quadrupod position. - trunk extension in prone lying - avoid flexn exercises & also rotational in sitting or staring. (In daily routine too) Ultrasound for triggered point & kneeding & MFR. will definitely reduce her pain. I had treated recently exact patient. -

Thoracolumbar scoliosis Xray thoracolumbar spine for further assessment Taylor's brace will help

It may be only myofascial pain due to weak back muscles. Give muscle relaxants with diclofenac . Physiotherapy is must , Back extensors strengthening and abdominal exercise with IFT and TENS will help.

But since 7 years?
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Get cbc then plan treatment.

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