Back Pain

Question 1

How does differential diagnosis change between skeletally mature and immature patients?

Answer 1

If they are skeletally mature it is more likely back pain is coming from some kind of muscle pain

If they are skeletally immature, back pain is most likely being caused by problems in the bones

Question 2

What is the best treatment for mechanical low back pain?

Answer 2

Early mobilization
Physical Therapy
Core Stabilization
Adjustment/Manipulation
Massage (Rolfing)

Question 3

What is the best pain management for mechanical low back pain?

Answer 3

NSAIDS
Steroids (Prednisone)
Narcotics
?Muscle Relaxants
Ice, Heat, Modalities
Electrical Stimulation

Question 4

What is the best way to prevent and manage mechanical low back pain?

Answer 4

Improve fitness
Lifestyle changes
Decrease stress
Different employment
Quit smoking

Question 5

How does an acute herniation present?

Answer 5

Low back pain
sciatica (pain down the leg)
Often event precipitated
sensory or motor issues

Question 6

Physical findings of disc herniation?

Answer 6

spllnting

straight leg raise - if you lift the leg straight up it will pull on the nerve and cause pain

Question 7

Disc herniation treatment?

Answer 7

rest
oral steroids
pain meds
TIME!!!! (takes a while)

Question 8

Indication for surgery in disc

Answer 8

pain
MRI
motor weakness
radicular symptoms

Question 9

In 10 year follow up, what is the difference between Surgery vs. Non-surgical Treatment?

Answer 9

No Difference in Functional Outcome

Question 10

Back pain in children

Answer 10

less likely to be machanical