DSA Back pain

Question 1

What are 2 protective factors low back pain?

Answer 1

1. Regular excercise

2. education

Question 2

What are 3 risk factors for low back pain?

Answer 2

1. lifting
2. smoking
3. depression

Question 3

What is the most common cause of back pain?

Answer 3

Mechanical (90%)

Question 4

2 % of low back pain is due to ?

Answer 4

visceral etiologies (GI organs, abdominal aorta , renal , endometriosis)

Question 5

1 % of low back pain is due to ?

Answer 5

nonmechanical etiologies ( neoplasms. infection, inflammatory)

Question 6

Strain of which 3 back muscles contributes to lower back pain?

Answer 6

1. paraspinals (multiifidus / rotatores)
2. erector spinae
3. quadratus lumborum

Question 7

Injury to what 2 ligament contributes to low back pain?

Answer 7

1. iliolumbar

2. sacroiliac

Question 8

Aching/ burining pain in gluteal region, paresthesia down posterior thigh is ________?

Answer 8

Piriformis syndrome

Question 9

What makes the pain worse in piriformis syndrome?

Answer 9

sitting

Question 10

What test is used to Dx piriformis syndrome?

Answer 10

FAIR test. (lie lateral recumbent, flex, adduct. internal rotation)

Question 11

Patient with pain at thoracolumbar junction or hip pain at the insertion tendon is ?

Answer 11

psoas syndrome

Question 12

Psoas syndrome is made worse by?

Answer 12

lumbar extension

standing straight

Question 13

What tests are used to dx psoas syndrome?

Answer 13

1. Thomas test

2. Pelvic Shift

Question 14

A Patient with psoas syndrome on the left will have a _____ sided pelvic shift test?

Answer 14

RIGHT (it is opposite the dysfunction

Question 15

If patients pelvis translates easy to the left they have a ______ sided. psoas syndrome/?

Answer 15

RIGHT

Question 16

Short leg syndrome is due to ?

Answer 16

sacral base unleveling

Question 17

Pt with scoliosis may be at increased risk for _____?

Answer 17

Short leg syndrome

Question 18

Short leg syndrome pain is made worse by?

Answer 18

activity or walking

Question 19

What test for short leg syndrome?

Answer 19

pelvic side shift. (does not resolve with manipulation)

Question 20

A left anatomic short leg will have a ______ pelvic side shift test)

Answer 20

RIGHT

Question 21

A flexible pt with short leg syndrome you will treat by adding ______‘inches every two weeks

Answer 21

1/8

Question 22

A fragile pt with short leg syndrome you will treat by adding ______ inches every two weeks

Answer 22

1/16

Question 23

If pt loses height right after surgery how should you approach treatment?

Answer 23

replace the full length immediately , you dont need to do increments

Question 24

bending forward, sneezing, coughing, can excacerbate someone who has?

Answer 24

Degenerative disc disease

Question 25

Discogenic pain is characteristic for?

Answer 25

Degenerative disc disease

Question 26

Defect or stress fracture of pars interarticularis?

Answer 26

spondylolysis

Question 27

Pain pattern for spondylolysis?

Answer 27

pain most common at L5

Question 28

Who is at increased risk for sponylolysis?

Answer 28

young athletes ( repetitive stress/ developing bones)

Question 29

What makes the spondylolysis pain worse?

Answer 29

hyperextension (posterior stress)

Question 30

Posterior stress makes ______ worse , Anterior stress makes _______ worse?

Answer 30

Spondylolysis, Degenerative disc disease

Question 31

Scotty dog finding on lumbar Xray?

Answer 31

spondylolysis

Question 32

Anterior displacement of vertebrae secondary to bilarteral pars defects?

Answer 32

Spondylolistheisis

Question 33

What are 2 things that increase risk for Spondylolistheisis?

Answer 33

1. Age (osteoarthritis) | 2. bilateral spondylolysis

Question 34

What makes the pain worse in Spondylolistheisis?

Answer 34

extension and activity

Question 35

How do you dx Spondylolistheisis?

Answer 35

palpable step off on PE

Question 36

What increases risk of compression fracture?

Answer 36

age <55 osteoporosis menopause malignancy (cancer)

Question 37

WHat makes a compression fracture pain worse?

Answer 37

sitting spine extension valsalva maneuveur

Question 38

Someone that presents with acute ATRAUMATIC PAIN, likely has ?

Answer 38

compression fracture

Question 39

Narrowing of the neural foramen or central canal?

Answer 39

spinal stenosis

Question 40

Unilateral numbeness of which nerve roots in spinal stenosis?

Answer 40

L4/L5/S1

Question 41

Standing/ walking make spinal stenosis ________, (better/worse) and sitting/lying down makes it _________

Answer 41

Worse, better

Question 42

Shopping cart sign is indicative of ?

Answer 42

spinal stenosis

Question 43

compression of nerve roots due to herniation of nucleous pulposis through annulus fibrosis?

Answer 43

Herniated disc

Question 44

Most common lumbar discs involved?

Answer 44

L4/L5 (L5 nerve roots | L5/S1 (S1 nerve roots)

Question 45

What motion makes herniated disc worse?

Answer 45

flexion

Question 46

CAuda equine is due to a ?

Answer 46

disc herniation

Question 47

What is the pain pattern of cauda equina?

Answer 47

1. saddle anesthesia 2. fecal / urinary incontinence 3. numbness /tingling

Question 48

What increases risk of cauda equina?

Answer 48

TRAUMA

Question 49

When should you order imaging for low back pain?

Answer 49

1. progressive neurologic deficit 2. saddle anesthesia 3. deep bone pain (neoplasms) 4. fever/ chills (osteomylitis)

Question 50

What conditions make up Greenmans Dirty HalF dozen?

Answer 50

1. Muscle imbalance- 100% 2. lumbar spine type 2 -84% 3. pubic symphisis dysfunction -75% 4. short leg- 63% 5. sacral extension- 48% 6. innominate shear- 24%