Back pain

Question 1

Definition of mechanical back pain?

Answer 1

Recurrent relapsing and remitting back pain with no neurological symptoms.

Question 2

Which type of back pain is worsened by activity and better with rest?

Answer 2

Mechanical

Question 3

Signs of non-mech?anical back pain

Answer 3

worse w rest. Better w/ activity

Sig. early morning stiffness

Question 4

Possible causes of mechanical back pain?

Answer 4

• Obesity
• Poor posture
• lack of physical activity
• spinal stenosis
• degenerative disc prolapse
• facet joint OA
• spondylosis.

Question 5

Non-mechanical back pain causes?

Answer 5

Inflammatory causes. Infections. Tumours.

Question 6

Red Flags for back pain?

Answer 6

• Age <20 or >60 when first instance of back
• Non-mechanical constant paib
• Previous carcinoma (breast, bronchus, prostate)
• Immunocompromise (steroids, HIV)
• General malaise, fever, unexplained weight loss
• Widespread neurological symptoms
• Structural spinal deformity
- Saddle anaesthesia/ parathesia +/- loss of bowel/bladder control
- Severe pain > 6 weeks

Question 7

If there are red flags or surgery is being considered, which investigation should be done?

Answer 7

MRI

Question 8

What does general treatment of back pain involve?

Answer 8

Analgesia + physio and mobility.

Question 9

Why isnt bedrest suggested?

Answer 9

It leads to stiffness and back spasms.

Question 10

Indications for spinal stabilisation?

Answer 10

SIngle level vertebrea affected by OA or instability and no improvement w/ physio & conservative management.