Back Pain Flashcards
Cause of back pain?
Trauma Infection Tumour Referred pain Inflammatory Degenerative
Inportant causes of back pain to rule out?
Cauda equina
Spinal fracture
Neoplasm
Infection
Back pain red flags?
Acute, rapidly progressing Constitutional symptoms History of malignancy Bladder/ bowel Bilateral pain / weakness Pain lying flat First time presentation
Investigations for back pain?
CT
MRI
X-ray
Features of cauda equina?
Bilateral leg weakness
Incontinence
Reduced anal tone
Saddle anaesthesia
Features of a spinal fracture?
Sudden onset
Vertebral body tenderness
History of trauma
Pain relieved by lying down
Features of a neoplasm causing back pain ?
>50 Severe pain Gradual onset Localised tenderness Previous malignancy Persistent pain Weight loss
Features of potential infection causing back pain?
Fever Diabetes TB or recent UTI IVDU Immunocompromised state
Lumbar clinical syndromes?
Sciatica
Spinal stenosis
Cauda equina
Features of sciatica ?
Leg main more so than back pain
Sharp shooting pain
Radicular
Worse on stretch and standing, better lying down with knee bent
Features of spinal stenosis?
Back pain more so than leg pain Brought about by walking Claudication distance Chronic bladder/bowel Gradual bilateral leg weakness
Management of back pain?
Activity Analgesia Advice on siting and lifting Physio and exercises Injections Surgery
Analgesia for back pain?
NSAIDs Opiates Amitryptaline Gabapentin Muscle relaxants
Injections used for relief of back pain?
Long acting anaesthetic / steroid
Facet joint injection
Peri-root injection
Surgery for back pain?
Lumbar laminectomy
Vertebroplasty
Posterior lumbar inter body fusion
Decompressive procedures
