Back Pain Flashcards
what are the functions of the spine?
to allow movement, to protect the spinal nerves, to act as a shock absorber
which part of the spine is most mobile and why?
the cervical part and because it has relatively thick discs in comparison to the size of the adjacent vertebrae
what are the 3 spinal curves?
the cervical lordosis, thoracic kyphosis, and the lumbar lordosis
why are the spinal discs more vulnerable to injury in the morning?
they are swollen with water so the annulus and intervertebral ligaments resist bending strongly
what happens to discs as we age and how do we compensate for this?
they become thinner, lose water and strength, therefore new bone called osteophytes grow to stabilise the spine
what are the backpain classifications?
simple backache, nerve root involvement, possible serious spinal injury
what is mechanical or simple backpain?
it is the first episode with often sudden onset whilst exerting back, there can be recurrent episodes with decreasing inter-episode frequency, and it is variable relative to position
what are some drug treatments for LBP?
NSAIDs, paracetaemol, opiods, anti-depressants as often related to mental health and nerve modulators such as gabapentin
what is sciatica?
when the sciatic nerve L4 to S3 is involved so pain radiated from back to leg below knee, the commonest neurological sign is loss of ankle jerk
what are some red flag symptoms for serious spinal pathology?
age - young or old at first onset, history of carcinoma, weigh loss, constant, UTI or infection, IV drug abuse or HIV positivity, pain worse at rest, no response to treatment
what are some risk factors for osteoporosis?
smoking, alcohol, steroids, family Hx, inflammatory conditions, age, female
what is rheumatological back pain?
degenerative disease - mechanical back pain and can be from axial spondyloarthritis, osteoporosis, osteomalacia, paget’s disease, infection adn tumours
what are risk factors for osteomalacia?
diet and sunlight are impacting factors
where is the most common site of Paget’s disease and what is a sign?
the pelvis and the individual has raised alkaline phophatase
what are symptoms of cauda equina syndrome?
difficulty with micturition, loss of anal sphincter tone or faecal incontinence, saddle anaesthesia, lower back or leg pain
