Psychological distress is a common reaction to the suffering aspects of acute back pain, even when symptoms are short-term and not medically serious [35]’( (IASP, 2021)

Diagnosis
Initial assessment of back pain consists of a history and physical examination. Important characterizing features of back pain include location, duration, severity, history of prior back pain and possible trauma. Other important components of the patient history include age, physical trauma, prior history of cancer, fever, weight loss, urinary incontinence, progressive weakness or expanding sensory changes, which can indicate a medically urgent condition.Physical examination of the back should assess for posture and deformities. Pain elicited by palpating certain structures may be helpful in localizing the affected area. A neurologic exam is needed to assess for changes in gait, sensation and motor function. Determining if there are radicular symptoms, such as pain, numbness or weakness that radiate down limbs, is important for differentiating between central and peripheral causes of back pain. The straight leg test is a maneuver used to determine the presence of lumbosacral radiculopathy, which occurs when there is irritation in the nerve root that causes neurologic symptoms such as numbness and tingling. Non-radicular back pain is most commonly caused by injury to the spinal muscles or ligaments, degenerative spinal disease or a herniated disc. Disc herniation and foraminal stenosis are the most common causes of radiculopathy.Imaging of the spine and laboratory tests is not recommended during the acute phase. This assumes that there is no reason to expect that the patient has an underlying problem.
There are also connections with the pterygoid plexus of veins via inferior ophthalmic vein, deep facial vein and emissary veins. Contents
Apart from the blood which passes through a venous sinus, several anatomical structures, including some cranial nerves and their branches, also pass through the sinus.Structures within the outer (lateral) wall of the compartment from superior to inferior:
Oculomotor nerve
Trochlear nerve
Ophthalmic and maxillary branches of the trigeminal nerveStructures passing through the midline (medial) wall:
Abducens nerve
Internal carotid artery accompanied by the internal carotid plexusThese nerves, with the exception of CN V2, pass through the cavernous sinus to enter the orbital apex through the superior orbital fissure. The maxillary nerve, division V2 of the trigeminal nerve travels through the lower portion of the sinus and exits via the foramen rotundum. The maxillary branch passes external to, but immediately adjacent to, the lateral wall of the sinus.The optic nerve lies just above and outside the cavernous sinus, superior and lateral to the pituitary gland on each side, and enters the orbital apex via the optic canal. Function
Venous drainage
As a venous sinus, the cavernous sinus receives blood from the superior and inferior ophthalmic veins and from superficial cortical veins, and is connected to the basilar plexus of veins posteriorly. The cavernous sinus drains by two larger channels, the superior and inferior petrosal sinuses, ultimately into the internal jugular vein via the sigmoid sinus, also draining with emissary vein to pterygoid plexus. Clinical significance
It is the only anatomic location in the body in which an artery travels completely through a venous structure.