Back pain

Question 1

What are the main red flag symptoms for back pain?

Answer 1

-Aged <20 or >55 y/o
-Acute onset in elderly
-Constant or progressive pain
-Fever, night sweats, weight loss
-Abdominal mass
-Pain worse at night / on being supine
-Leg pain
-Neurological disturbance
-Incontinence

Question 2

What are the most likely causes of back pain in 15-30 y/o’s?

Answer 2

-Prolapsed disc
-Trauma
-Fractures
-Ankylosing spondylitis
-Pregnancy

Question 3

What are the most likely causes of back pain in 30-50 y/o’s?

Answer 3

-Degenerative spinal disease
-Prolapsed disc
-Malignancy

Question 4

What are the most likely causes of back pain in >50s?

Answer 4

-Degenerative
-Osteoporotic vertebral collapse
-Paget’s
-Malignancy
-Myeloma
-Spinal stenosis

Question 5

What is the best long-term management for non-specific back pain?

Answer 5

-Encourage movement and to remain active
-Regular ibuprofen / paracetamol / codeine
-Low-dose amitriptyline
-Naproxen
-Offer physio, acupuncture, exercise programme