Back Pain - approach + simple back pain

Question 1

First rule out life-threatening visceral pathology (???, ??, ?);
o Observations, targeted ? and ?-? examination plus ?/ blood tests if suspected.

?% of complaints regarding back pain are due to ‘? ?’ back pain, which will generally resolve ?.

Answer 1

AAA
MI
Pancreatitis
abdo
cardio-resp
ECG

90
simple mechanical
spontaneously

Question 2

Assess for ‘red flag’ symptoms that indicate more severe pathology;

o Age  or >?.
o ? or ? pain (including pain at ?).
o ? symptoms.
o ?/? symptoms.
o History of ??/???/malignancy.
o Pain in the ? spine.
o History of significant ?
.
The most important examination 'red flag' signs are ? ? (cauda equina) and ? ? tenderness on palpation (malignancy).

Answer 2

20
55
progressive
constant
night
B
bowel/bladder
TB/HIV
thoracic
trauma

saddle anaesthesia
point midline

Question 3

Simple mechanical back pain;

Patient presents with pain in the ? region.
o ?-? year old, pain came on suddenly when ?.
o Pain classically varies with physical activity, ?, ?.
o Pain may be referred to the ? and ?.
o On examination there may be palpable ? ?, which can
cause local pain / ?.

Answer 3

lumbosacral
20-55
lifting
posture
time
buttocks
thighs
muscle spasms
tenderness

Question 4

Simple mechanical back pain;

A diagnosis of ?-? lower back pain can be reached when the clinician is satisfied there is no specific cause for the pain.
Management is with simple ?, and advice to keep ? with normal activities plus ?exercises.

Answer 4

non-specific
analgesia
active
physiotherapy

Question 5

Simple mechanical back pain;

Prognosis is ?: ?% recover from the acute attack within six ?.
Re-assess at ? weeks if the pain has not resolved

Answer 5

good
90
weeks
six