CBD for a spine condition

Question 1

Infection red flags

Answer 1

Fever or recent infection, history of malignancy, immunocompromised

Question 2

Cauda equina red flags

Answer 2

Bilateral deficit legs, urinary retention, faecal incontinence,
perianal sensory loss

Question 3

Cancer red flags

Answer 3

50+ y/o
Gradual symptom onset
Unremitting pain, even when supine
Localised spinal tenderness
Pain worse when lying down and at night

Question 4

Spinal fracture red flags

Answer 4

Sudden onset of pain relieved when lying down
History of major trauma
Structural spinal deformity

Question 5

Which cancers can spread to bone?

Answer 5

myeloma, breast, lung, prostate, colon, renal, thyroid

Question 6

Investigation for back pain

Answer 6

MRI
Examination of gait and GALS
FBC - CRP rise in cancer and infection 
Neurological exam
PR exam
U and Es
ALP (liver and bone)

Question 7

Management of back pain

Answer 7

• Analgesics - paracetamol, codine, tramadol, opiates to opioids
• Escalate WHL pain ladder
• MRI within 4hrs
• If caused by cancer, could give dexamethasone