Control CS2 back pain Flashcards
What are 3 functions of the spine?
Allow movement
Protects spinal nerves
Acts as a shock absorber (with the legs)
What are the 3 curves of the spine?
Cervical lordosis
Thoracic kyphosis
Lumbar lordosis
What advice is given to patients with low back pain? Why?
Keep flexible
Keep strong
Prevents muscle weakness and wasting and loss of movement
What are risk factors for back pain?
Genetics
Environment e.g. occupation
Body weight
Muscle strength
Overloading
What is lower back pain?
Mechanical back pain in the lower back with nerve root involvement and possibly a serious spinal pathology
How is back pain treated?
Pain management programmes
Physiotherapy
Weight loss
Simple analgesics e.g. paracetamol
What drugs should be avoided in treating back pain?
Opioids
NSAIDS in long term
Nerve modulators like gabapentin and pregabalin due to addictive nature
What drugs are recommended to treat back pain?
Paracetamol
Anti-depressants (help sleep) e.g. amitriptyline or duloxetine
What is axial spondylitis?
Who is affected?
What diseases are associated with it?
Inflammatory arthritis of the spine causing pain and stiffness of the spine alongside other joint inflammation and eye inflammation. If untreated, spine fuses.
Affects young people (men>women)
Associated with IBD and psoriasis
What is sciatica?
What nerves are affected?
What are associated symptoms?
Pain radiating from the back to the leg BELOW the knee
L4 to S3
Pins and needles in leg, numbness and weakness, loss of ankle jerk and foot drop.
What are red flag symptoms for back pain?
Age of first onset
History of carcinoma (lung, bone, thyroid, prostate, kidney)
Weight loss
Constant 24h pain for more than a month
No response to treatment
Pain worse at rest
History of IV drug abuse
Poorly controlled HIV or immunosuppresion
Infections
What are symptoms of inflammatory back pain?
Insidious onset
Nocturnal pain and early morning stiffness
Better with exercise
Worse with rest
Family history (like colitis or psoriasis)
Bum pain
What are risk factors for osteoporosis?
Age
Female (due to oestrogen)
Smoking
Steroids
Alcohol
Early menopause
Family history
Inflammatory conditions
What is Paget’s disease?
Raised alkaline phosphate and increased bone density/turnover. Usually in the pelvis causing pelvic and back pain.
What is cauda equina syndrome?
Difficulties urinating, loss of anal sphincter tone +/- faecal incontinence, anaesthesia of buttocks/saddle, and low back +/- leg pain
