Flashcards
Back Pain
Cards in this deck (36)
- 1What are the most likely causes of back pain in 0-15 year olds?Osteochondritis and scoliosis
- 2What are the most likely causes of back pain in 15-30 year olds?Prolapsed intervertebral disc, trauma, fractures, ankylosing spondylitis, spondylolisthesis, pregnancy
- 3What are the most likely causes of back pain in 30-50 year olds?Prolapsed intervertebral disc, carcinoma (breast, lung, prostate, thyroid and kidney), degenerative disease
- 4What are the most likely causes of back pain in over 50 year olds?Degenerative disease, osteoporosis, Paget's disease, carcinoma and myeloma
- 5What is the lifetime risk of developing back pain?70%
- 6What is the commonest age range onset for back pain?35-55
- 7Which spinal regions does spondylosis most commonly occur in?Cervical and lumbar
- 8What are the characteristics of spondylosis back pain?Chronic or intermittent pain, often after physical activity
- 9What are the associated features of spondylosis?Acute exacerbations, reduced spinal mobility, stiffness and muscle spasms
- 10What are the complications of spondylosis?Intervertebral disc prolapse, spinal stenosis and spondylolisthesis
- 11What are the treatment options for spondylosis?Medical: analgesia, NSAIDs, support corsets, MDT involvement
Surgical: spinal fusion and surgical decompression (only used in severe cases) - 12When does 'simple low back pain' most commonly present? (age group)20-55
- 13What are the features of simple low back pain?Lumbosacral, buttock and thigh pain. Mechanical in nature, varies with activity and time
- 14How long does simple low back pain typically take to resolve?Within 6 weeks
- 15How does nerve root pain present differently to back pain?Likely to present with more leg pain than back pain
- 16What are the characteristics of nerve root pain?Unilateral leg pain that may radiate to calf, foot or toes. Numbness, parasthesia and local neurological signs may also be present
- 17Red flag? - Age of onset 20-55No
- 18Red flag? - Age of onset <20 or >55Yes
- 19Red flag? - Constant, non-mechanical painYes
- 20Red flag? - Intermittent, mechanical pain?No
- 21Red flag? - Thoracic painYes
- 22Red flag? - Cervical painNo
- 23Red flag? - Lumbar painNo
- 24Red flag? - Past medical history of carcinomaYes
- 25Red flag? - Drug misuse, steroid therapy, HIVYes
- 26Red flag? - Presence of neurological symptomsYes
- 27Red flag? - Absence of neurological symptomsNo
- 28Red flag? - Severe, persistent restriction of lumbar flexionYes
- 29What is an intervertebral disc prolapse?Extrusion of the nucleus pulposus posterolaterally causing bulging or rupture of the annulus fibrosis
- 30Which intervertebral levels are most prone to disc prolapse?L4-S1
- 31Which nerve root is compressed if these symptoms present? - Sensory loss over anterior thigh. Weak hip flexion, adduction and knee extensionL2 (L1/L2 disc prolapse)
- 32Which nerve root is compressed if these symptoms present? - Sensory loss over medial thigh and knee. Weak hip flexion, adduction and knee extension. Reduced knee reflexL3 (L2/L3 disc prolapse)
- 33Which nerve root is compressed if these symptoms present? - Sensory loss over medial aspect of calf. Weak knee extension. Reduced knee reflexL4 (L3/L4 disc prolapse)
- 34Which nerve root is compressed if these symptoms present? - Sensory loss over dorsum of foot. Weak hallux extensionL5 (L4/L5 disc prolapse)
- 35Which nerve root is compressed if these symptoms present? - Sensory loss over posterior calf and sole of foot. Weak foot plantar flexion. Reduced ankle reflex and calf painS1 (L5/S1 disc prolapse)
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