Back Pain Flashcards
1
Q
what is mechanical back pain?
A
- majority of back pain in adults
- lower
- occurs after straining
- relieved by rest
- paraspinal tenderness
2
Q
what are the red flags for back pain?
A
- new onset age =/<20 or =/>50
- thoracic or cervical spine pain
- pain is progressive or not relieved by rest
- spinal (rather than paraspinal) tenderness
3
Q
how is mechanical back pain diagnosed?
A
diagnosis of exclusion
4
Q
how long does it take for mechanical back pain to resolve?
A
6 weeks
5
Q
what investigations should be undertaken in mechanical back pain?
if prolonged or have red flag symptoms
A
- x-ray or urgent MRI (if neurological)
- myeloma screen
- referral to ortho or neurosurgery
6
Q
what are the features of ankylosing spondylitis back pain?
A
- prolonged morning stiffness
- improved with movement
- alternating buttock pain
7
Q
what are the features of bone metastasis/myeloma back pain?
A
- history of cancer
- systemic cancer symptoms (e.g. fever/weight loss/night sweats)
8
Q
what are the features of discitis back pain?
A
- systemic infection symptoms (e.g. fever/weight loss/night sweats)
- immunosuppresion
- IV drug usage
9
Q
what are the features of vertebral back pain?
A
violent trauma
10
Q
what are the features of cauda equina syndrome/spinal cord compression back pain?
A
- new urinary or faecal retention or incontinence
- poor anal tone or reduced perineal sensation (saddle anaesthesia)
- bilateral lower limb neurology (alternating or simultaneous)
11
Q
what are the features of nerve root compression back pain?
A
- normally unilateral (unless there is bilateral disease)
- burning/shooting pain down the leg
- positive sciatic stretch test
- dermatomal stretch test positive
- reduced reflexes
12
Q
what cancers metastases to the bone?
A
BLT with a Kosher Pickle
- Breast
- Lung
- Thyroid
- Kidney
- Prostate
