back anatomy and management of slipped disc Flashcards
what is non specific low back pain
pain not due to any specific/underlying disease that can be found
what is mechanical low back pain
pain after abnormal stress and strain on vertebral column
what is nerve root pain/ sciatica
pain radiating to lower limbs with/without neuralgic symptoms
what is the most common cause of lower back pain
mechanical - 90%
other than mechanical what are some causes of back pain
tumour including myeloma infection (staph cocc most common, then tb) spondyloarthropathy pars interarticularis injury compression fracture visceral
nice guidance for imaging
- dont routinely offer imaging in non specialist setting for people with low back pain with/without sciatica
- explain to people with low back pain wit/without sciatica that if they are being referred to specialist, they may not need imaging
- consider imaging in specialist setting
(only if result is likely to change management)
treatment options for back pain according to nice
injections excercise manipulation psychological therapy nsaids epidural weak opioids less used: corsets, traction, acupuncture,opioids,spinal fusion, disc replacement.
conservative treatment for low back pain
analgesia (paracetamol) anti inflammatory drugs manipulation acupuncture massage allow time to pass *most patients get better spontaneously
red flags for lower back pain
weightloss
fever
night pain
under 19
red flags for leg pain
bowel/bladder dysfunction
saddle anaesthesia
profound neurological defict
what are some risks of metastases?
catastrophic fracture and paralysis
primary imaging investigation for lower back pain
mri
secondary imaging investigations for lower back pain
radiographs
ct
pros and cons of radiographs
cheap, readily available, traditional
radiation and overlook most important diseases
