Back pain and sciatica Flashcards
What does it indicate if the pain radiates to the buttock?
muscle pain
What does it indicate if the pain radiates below the knee?
disc problem
What must you try and for how long before referring to a neurologist?
6weeks analgesia
What are the risk factors for back pain?
previous back pain
heavy lifting
smoking and obesity
repetitive work with exposure to vibration
What are the general red flags for back pain?
failure to improve after 6 weeks analgesia
unrelenting night pain or pain at rest
progressive motor or sensory smyptoms
What are the cancer red flags for back pain?
> 50yrs old
unintented weight loss
history of cancer
pain at night or when lying down
What are the infectious red flags for back pain?
fever/chills immunosuppression IV drug use forgein travel or recent infection dental status
What are the fracture red flags for back pain?
age >50
osteoporosis
significant trauma
steroid use
What are the cauda equina syndrome red flags for back pain?
bilateral sciatica urinary incontinence leg weakness decreased/absent anal tone loss of perianal sensation
What are the AAA red flags for back pain?
age >60
abdominal pulsating mass
pain at rest
When would you MRI a patient?
any red flags
Why are CT scans good?
good for bone pathology, forgein bodies, implants and spinal fusion planning
Why are MRI scans good?
good for soft tissue, tumours, infections, new fractures, bone oedema/microfractures
When would you Xray?
if ankylosing spondylitis is suspected
What do PET scans and radionucleotide bone scans show?
shows increased bone turnover
