Back Pain Flashcards
What is discogenic back pain?
Persistent lower back pain with or without groin/leg pain
At what age is discogenic back pain most common?
Peak incidence at 40 years
What are the typical pain referral patterns for the L3/4 disc level?
Anterior thigh
Where does pain from the L4/5 disc level typically refer to?
Lateral thigh
What is the referral pattern for pain from the L5/S1 disc level?
Posterior thigh
Name two risk factors for discogenic back pain.
Obesity, smoking
What activities aggravate discogenic back pain?
Sitting, driving, lumbar flexion, bending, twisting, coughing
Name the layers of the intervertebral disc.
Outermost annulus, inner annulus, transitional zone, nucleus pulposus
What is a disc bulge?
Nucleus pulposus contained within annulus fibrosus
How does a disc extrusion differ from a protrusion?
Extrusion extends beyond the annulus fibrosus
What is sequestration in disc terminology?
Herniation fully beyond annulus fibrosus
Name one X-ray finding in disc degeneration.
Reduced disc space
What is the first stage of disc degeneration?
Dehydration
What causes chronic pain in disc degeneration?
Inflammatory mediator extravasation
What percentage of individuals over 40 show spondylosis on X-rays?
Over 80%
Name one symptom of radicular pain.
Paraesthesia
What condition is indicated by saddle anaesthesia and bilateral symptoms?
Cauda equina syndrome
What relieves pain in spinal stenosis?
Sitting
What posture is often seen in patients with spinal stenosis?
Forward flexion
Name two non-surgical management strategies for back pain.
NSAIDs, prescribed exercises
What surgical option involves removal of part of the vertebra?
Laminectomy
What is the function of an interspinous spacer (e.g., X-STOP)?
Relieves pressure on the spinal column
Name a risk factor for spinal stenosis.
Degenerative disc disease
What symptoms suggest a motor deficit in radicular pain?
Foot drop
What activity aggravates radicular pain?
Prolonged sitting
