Backpain

Question 1

How can you relive back pain?

Answer 1

1. Stay active
2. Try exercises and stretches
3. Rake anti inflammatory ibuprofen
4. Use hot or cold compression packs

Question 2

What sort of support can you get for back. pain?

Answer 2

1, group exercises

2. Manual therapy treatments
3. psychological support

Question 3

What medical conditions can cause back pain?

Answer 3

• prolapsed disc
• sciatica
• ankylosing spondylitis
• spondylolisthesis

Question 4

How can you prevent back pain?

Answer 4

1. Regular exercises and stretches
2. Stay active
3. Avoid sitting for long periods of time
4. Take care when lifting
5. Check posture when sitting
6. Ensure mattress on bed supports
7. Lose weight

Question 5

What is non specific back pain?

Answer 5

there’s no obvious cause

Question 6

What is mechanical back pain?

Answer 6

the pain originates from the joints, bones or soft tissues in and around the spine

Question 7

What can back pain be a sign of?

Answer 7

• a broken bone in the spine
• an infection
• cauda equina syndrome
• some types of cancer, such asmultiple myeloma(a type of bone marrow cancer)

Question 8

When would radio-frequency denervation be used?

Answer 8

• you’ve had back pain for a long time
• your pain is moderate or severe
• your pain is thought to originate from the joints in your spine

Question 9

When is spinal fusion surgery recommended?

Answer 9

significant damage to the bones in your back (vertebrae)

Question 10

What is somatic topic arrangement?

Answer 10

different areas of the body correspond to different areas on this somatosensory cortex of the brain

Question 11

What is contralateral arrangement?

Answer 11

left side of this matter represents the right side of the body and the ride side of the somatosensory cortex represents the left side of the body

Question 12

What can stimulation of the cingulate cortex cause?

Answer 12

aversion

Question 13

What can stimulation of the insula cause?

Answer 13

vasoconstriction, sweating and increase in pulse rate

Question 14

What can stimulation of the amygdala cause?

Answer 14

fear

Question 15

What can stimulation of the reticular formation cause?

Answer 15

arousal

Question 16

Where does touch decussation happen?

Answer 16

At medulla oblongata

Question 17

Where do the neurones synpase?

Answer 17

• Medulla oblangata

- Thalamus

Question 18

What is this. highway called for touch?

Answer 18

Dorsal medial lemniscus system

Question 19

What do pain receptors need to initiate an action potential?

Answer 19

higher stimulus

Question 20

What is transduction?

Answer 20

process by which a stimulus is converted to an action potential - the stimulus can be mechanical, thermal or chemical

Question 21

Why do we feel pain at the site of inflammation?

Answer 21

7. Chemoreceptors initiate an action potential in response to cytokines that are generally reeled at the site of inflammation

Question 22

What tract does pain take?

Answer 22

Spinal thalamic tract

Question 23

What are the two sub sections of the spinal thalamic tract?

Answer 23

• Fast (sharp pain)

- Slow (dull pain)

Question 24

What is sharp pain carried by?

Answer 24

Adelta fibres

Question 25

What is dull pain carried by?

Answer 25

c fibres

Question 26

Why do the different fibres have different speeds?

Answer 26

different in thickness and myelination

Question 27

Where do synapses occur in the spinothalamic tract?

Answer 27

dorsal horn of the spinal cord then to thalamus

Question 28

Where does decussation occur in the spinothalamic tract?

Answer 28

dorsal horn

Question 29

Where does the spinothalmic tract associate with?

Answer 29

1. S2 region for visual integration | 2. Insula that cause vasocontraction, sweating and increase in pulse rate

Question 30

Where does dull pain synapse/travel to?

Answer 30

dorsal horn (where dessucates) and then to reticular formation and then AP goes to thalamus then to area of somatosensory cortex

Question 31

Why does the reticular formation lead to staying awake?

Answer 31

eticular formation can lead to arousal and this is why slow dull pain can keep you awake

Question 32

Where else is the AP taken in dull pain?

Answer 32

- cingulate cortex, which intimates a sense of aversion | - amygdala which initiates a sense of fear

Question 33

What are red flags in cauda equina syndrome?

Answer 33

1. Bilateral sciatica 2. Severe of progressive bilateral neurological deficet of legs, such as major motor weakness with knee. extension, ankle eversion or foot dorsiflexion 3. Difficulty initiating micturition or impaired sensation of urinary flow - if untreated this may lead to irreversible urinary retention with overflow incontinence 4. Loss of sensation of rectal fullness, if untreated this may lead to irreversible faecal incontinence 5. Perianal, perineal or genital sensory loss (saddle anaesthesia or paraesthesia) 6. Laxity of anal sphincter - Consider assessment of anal tone but notes does not need to be performed in primary care

Question 34

What are some early warning signs for Cauda equina syndrome?

Answer 34

1. Loss of feeling/pins and needles between inner thighs or genitals 2. Numbness in or around your back passage or buttocks 3. Altered feeling when using toilet paper to wipe yourself 4. Increasing difficulty when you try to urinate 5. Increasing difficulty when you try to stop or control your urine flow 6. Loss of sensation when you pass urine 7. Leaking urine or recent need to use pads 8. Not knowing when your bladder is full or empty 9. Inability to stop a bowel movement or leaking 10. Loss of sensation when you pass a bowel motion 11. Change in ability to achieve erection or ejaculate 12. Loss of sensation in genitals during sexual intercourse

Question 35

Is cauda equina a medical emergency?

Answer 35

yes, occurs when a patient suffers compression to the spinal nerve roots inside the dura, beyond the termination of the spinal cord

Question 36

What is a common cause of cauda equina syndrome?

Answer 36

result of a prolapsed intervertebral disc, although rarely it can also be caused through infection or tumour

Question 37

What can be some of consequences of delayed treatment for CES?

Answer 37

paralysis, incontinence and impaired mobility

Question 38

What are red flags of CES?

Answer 38

- Pain that radiates below the knees bilaterally (on rare occasions this can be unilateral) - Bilateral lower limb numbness or weakness - Numbness either side of the buttocks and saddle area - Bladder and/or bowel disturbance (including difficulty passing urine, poor stream, loss of sensation) - Erectile dysfunction. - Loss of anal tone or impaired sensation on per rectal (PR) examination.