IX.

Ecologic Model
A. Hypothesis
Back pain can be caused by a wide variety of factors. These include structural problems
of the back, inflammation, muscle and soft tissue injury, secondary response to other diseases
or conditions, imbalances in body mechanics, and psychological/social factors, among others.
In the case of our client, there are secondary factors that trigger the low back pain. The
clients age and gender may also be a factor to the pain that the client has experienced. Also,
some other factors may be triggered by another factor.
B. Predisposing Factors
1. Host
Age: 61 years old
Sex: Female
Sponsylolisthesis typically occurs at L4-5, and elderly females are most
commonly affected. The L5 nerve root is usually compressed from lateral recess stenosis as a
result of facet and/or ligamentous hypertrophy. Each disc of the spine is designed much like a
jelly donut. As the disc degenerates from age or injury, the softer central portion can rupture
(herniate)
2. Agent
a. Mechanical
Spinal Stenosis: Spinal stenosis refers to narrowing of the spinal canal. There are
a variety of causes. The most common cause is a combination of degenerative spine
disease (osteoarthritis of the spine) and bulging or herniated discs.
Discogenic Disk Disease: Chronic back pain may be caused by degenerative
disk disease, which refers to a thinning and drying out of the disks over time that can
lead to altered spine mechanics and perhaps to nerve irritation. Most patients older
than the age of 40 will have some lumbar disk abnormalities found if an MRI is
performed (Boos, 2000).
Spondylolisthesis: Spondylolisthesis is a condition in which one vertebral body
slips forward over another. This can cause worsening of osteoarthritis, altered spine
mechanics, nerve root compression, or spinal stenosis.
b. Physical
- prolonged walking
c. Chemical
- intake of Caltrate
3. Environment
Biologic
- Elderly female
- Hypertensive
C. Ecologic Model

D. Analysis
The origin of back pain is not well-known and has never been fully described. Many
groups have given up trying to describe the cause of lower back pain and instead have
listed several conditions that are associated with the problem.
1. Biochemical and destructive origins (compression of the disk, herniation of
the disks, torsion, injury and vibration)
2. Destructive origins (infections, tumors, and rheumatoid disorder)
3. Degenerative problems (osteoporosis and spinal stenosis)
4. Other disorders (no clear physiologic cause)
Medical- Surgical Nursing 8th Edition, Vol.2 (pg. 1872-1873)
Joyce M. Black ; Jane Hokanson Hawks
E. Conclusion and Recommendation
Based on the statements above, the clients age and gender are some of the factors that
contribute to the chronic low back pain. Also, some other factors are triggered by another
secondary factor. Surgical interventions are needed to repair the bones and to ease the pain
that the client is experiencing. If the client is left untreated, various metabolic disorders may
arise and could worsen the clients condition.