Back pain and sciatica Flashcards
What are causes of mechanical back pain
Muscle or ligament sprain
Facet joint dysfunction
Sacroiliac joint dysfunction
Herniated disc
Spondylolisthesis
Scoliosis
Arthritis
What are the causes of neck pain
Muscle or ligament strain
Torticollis
Whiplash
Cervical spondylosis
What are red flag causes of back pain n
Spinal fracture
Cauda equina
Spinal stenosis
Ank spond
Spinal infection
what nerves form the sciatic nerve
L4-S3
Where does the sciatic nerve supply sensation to
lateral lower leg and foot
Where does the sciatic nerve supply motor function to
posterior thigh
lower leg
foot
How does sciatica present
Unilateral pain from the buttock radiating down to below the knee or feet
Shooting pain
Paraesthesia
Numbness
Motor weakness
What are the main causes of sciatica?
Herniated disc
Spondylolisthesis
Spinal stensosis
What test can help diagnose sciatica
Sciatic stretch test
Pt lies flat on back
Lift one leg with knee extended until limit of hip flexion
Dorsiflex ankle
sciatic type pain indicates sciatic nerve irritation
Symptoms improve with flexing the knee
What are the main cancers that metastasise to the bone
PORTABLE
Prostate
Renal
Thyroid
Breast
Lung
what is. the STarT back screening tool
Stratifies the risk of a patient presenting with acute back pain developing chronic back pain
What analgesia are advised
NSAIDs
Codeine alternative
Benzodiazepines for muscle pain - short term only 5 days
What are options for management of sciatica?
Amitriptyline
Duloxetine
What are specialist management options for chronic sciatica
Epidural corticosteroid injections
Local anaesthetic injections
Radiofrequency denervation
Spinal decompression
