Back Pain Flashcards
back pain red flags
age < 20 or > 55 years neurological disturbance sphincter disturbance bilateral / alternating leg pain current / recent infection fever, weight loss, night sweats history of malignancy morning stiffness nocturnal pain acute onset in elderly constant / progressive pain
what is mechanical back pain
relapsing + remitting back pain
worse with movement, relieved by rest
no red flag symptoms present
patients aged 20-60
causes of mechanical back pain
obesity poor lifting technique poor posture lack of exercise facet joint OA spondylosis
what is spondylosis
intervertebral disks lose water content with age
- less cushioning
- increased pressure on facet joints – secondary OA
Tx mechanical back pain
physiotherapy + analgesia
what is an acute disc tear
tear in annulus fibrosis of intervertebral disk
presentation of acute disc tear
acute onset pain, typically after lifting heavy object
pain worse on coughing - increased disc pressure
- 2-3 months to heal
complication of disc tear
herniation of nucleus pulposis through tear – impingement of exiting nerve root resulting in dermatomal pain + altered sensation and reduced myotomal power
roots of sciatic nerve
L4, L5, S1
describe radicular (nerve compression) pain in sciatica
burning pain radiating down back of thigh to knee + buttock
positive femoral stretch test indicated what
sciatica
a prolapse at L3/4 affects what root ?
L4 - lower of the 2 vertebrae is affected
symptoms of L4 root entrapment
pain down to medial ankle
loss of power quadriceps
reduced knee jerk
symptoms of L5 root entrapment
sensory loss dorsum of foot
weak dorsiflexion
reflexes intact
symptoms of S1 root entrapment
pain to sole of foot
reduced power plantar-flexion
reduced ankle jerks
