Back Pain

Question 1

What is discogenic back pain?

Answer 1

Persistent lower back pain with or without groin/leg pain

Question 2

At what age is discogenic back pain most common?

Answer 2

Peak incidence at 40 years

Question 3

What are the typical pain referral patterns for the L3/4 disc level?

Answer 3

Anterior thigh

Question 4

Where does pain from the L4/5 disc level typically refer to?

Answer 4

Lateral thigh

Question 5

What is the referral pattern for pain from the L5/S1 disc level?

Answer 5

Posterior thigh

Question 6

Name two risk factors for discogenic back pain.

Answer 6

Obesity, smoking

Question 7

What activities aggravate discogenic back pain?

Answer 7

Sitting, driving, lumbar flexion, bending, twisting, coughing

Question 8

Name the layers of the intervertebral disc.

Answer 8

Outermost annulus, inner annulus, transitional zone, nucleus pulposus

Question 9

What is a disc bulge?

Answer 9

Nucleus pulposus contained within annulus fibrosus

Question 10

How does a disc extrusion differ from a protrusion?

Answer 10

Extrusion extends beyond the annulus fibrosus

Question 11

What is sequestration in disc terminology?

Answer 11

Herniation fully beyond annulus fibrosus

Question 12

Name one X-ray finding in disc degeneration.

Answer 12

Reduced disc space

Question 13

What is the first stage of disc degeneration?

Answer 13

Dehydration

Question 14

What causes chronic pain in disc degeneration?

Answer 14

Inflammatory mediator extravasation

Question 15

What percentage of individuals over 40 show spondylosis on X-rays?

Answer 15

Over 80%

Question 16

Name one symptom of radicular pain.

Answer 16

Paraesthesia

Question 17

What condition is indicated by saddle anaesthesia and bilateral symptoms?

Answer 17

Cauda equina syndrome

Question 18

What relieves pain in spinal stenosis?

Answer 18

Sitting

Question 19

What posture is often seen in patients with spinal stenosis?

Answer 19

Forward flexion

Question 20

Name two non-surgical management strategies for back pain.

Answer 20

NSAIDs, prescribed exercises

Question 21

What surgical option involves removal of part of the vertebra?

Answer 21

Laminectomy

Question 22

What is the function of an interspinous spacer (e.g., X-STOP)?

Answer 22

Relieves pressure on the spinal column

Question 23

Name a risk factor for spinal stenosis.

Answer 23

Degenerative disc disease

Question 24

What symptoms suggest a motor deficit in radicular pain?

Answer 24

Foot drop

Question 25

What activity aggravates radicular pain?

Answer 25

Prolonged sitting