Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pre-clinical > Low Back Pain > Flashcards

Low Back Pain Flashcards

1
Q

What percentage of the UK population will experience low back pain in their lifetime?

A

Up to 60%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What percentage of adults under the age of 45 have chronic low back pain?

A

3-4%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What percentage of adults over the age of 45 have chronic low back pain?

A

5-7%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What accounts for 90-95% of cases of low back pain presenting in primary care?

A

Non-specific low back pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the risk factors for the development of chronic low back pain and disability?

A

Pain lasting longer than 12 weeks
High baseline pain intensity
Anxiety and/or depression
Stressful life events
Substance misuse
Maladaptive coping strategies
‘Fear and avoidance’

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Which group of people are most likely to experience low back pain?

A

Women and people aged 20-65

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the ‘red flag’ symptoms of low back pain?

A

Sphincter disturbances
Paraesthesia
Progressive weakness
Gait disturbances

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are some history factors to ask about in a patient with low back pain?

A

Trauma, malignancy, neurological conditions, inflammatory conditions, steroid use, IV drug use (red flag histories)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the key motor or sensory disturbances to ask about in low back pain?

A

Radiculopathy or cord compression symptoms (urinary retention or incontinence)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What symptoms may indicate renal tract issues or malignancy?

A

Haematuria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What sign may indicate inflammatory arthritis (such as rheumatoid arthritis or ankylosing spondylitis) with low back pain?

A

Early morning stiffness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the typical presentation for a lumbar strain or sprain?

A

Pain that improves with rest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What condition is indicated by lower back pain that worsens with prolonged sitting?

A

Lumbar disc disease, spondylosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What condition is indicated by lower back pain that worsens with valsalva?

A

Lumbar disc disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What posture should be checked when a patient is standing during a low back pain physical examination?

A

Cervical lordosis, thoracic kyphosis, lumbar lordosis and any asymmetry or muscle wasting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What deformity is associated with ankylosing spondylitis?

A

A ‘question mark’ spine - characterised by exaggerated thoracic kyphosis and loss of lumbar lordosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How should you palpate the lower back during a physical examination?

A

Palpate over the spinous processes, sacroiliac joints and paraspinal muscles, checking for tenderness or increased tone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What movement tests should be performed in a patient with low back pain?

A

Lateral flexion, lumbar flexion/extension, cervical and thoracic flexion/extension and rotation tests

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is Schober’s test used to assess?

A

Lumbar flexion - limited increase in distance between two marked points indicates abnormal lumbar movement

20
Q

How is the straight leg test performed?

A

Patient lying flat - lift the extended leg to assess for pain, checking for sciatic nerve irritation

21
Q

What is the gate control theory of pain?

A

Pain signals are modulated by ‘gates’ in the spinal cord that can be opened or closed by physical, emotional and mental factors

22
Q

What factors tend to open the ‘gates’ in the gate control theory?

A

Stress, anxiety, focusing on pain, boredom, inactivity

23
Q

What factors help to close the ‘gates’ and reduce pain perception?

A

Relaxation, optimism, mental engagement and physical activity

24
Q

What role does mental focus play in the gate control theory?

A

Concentrating on something other than pain can close the gates, while focusing on pain can open them and worsen the perception

25
Q

What is the purpose of the STarT back tool?

A

Categorises patients’ risk for chronic low back pain, enabling the assignment of appropriate treatment packages

26
Q

What are the 3 risk categories used in the STarT back tool?

A

Low, medium and high risk

27
Q

What type of treatment is recommended for patients identified as low risk using the STarT back tool?

A

Self-management, reassurance and medication

28
Q

What factors increase the risk of long-term disability and time lost from work in a patient with low back pain?

A

Pain lasting longer than 12 weeks, high baseline pain intensity, anxiety/depression, stress, substance misuse and maladaptive coping strategies

29
Q

What psychological factors are linked to an increased risk of disability from low back pain?

A

Anxiety, depression and catastrophising

30
Q

How can the perception of persistent pain affect recovery?

A

It can hinder recovery and contribute to chronic disability

31
Q

What are the main non-pharmacological interventions for managing low back pain?

A

Education, exercise, manual therapies (spinal manipulation/massage) and psychological therapy (e.g CBT)

32
Q

How does exercise contribute to the management of low back pain?

A

It helps improve fitness, reduces stiffness and promotes movement which can alleviate pain

33
Q

What psychological therapy is often used for back pain management?

A

CBT - addresses negative thoughts and behaviours related to pain

34
Q

How does MRI help in assessing spinal anatomy in patients with low back pain?

A

MRI helps identify abnormalities such as disc protrusions, vertebral metastases and lytic or sclerotic lesions in the spine

35
Q

How do you identify T1 vs T2 weighted MRI?

A

T1 highlights fat while T2 highlights fat and water

36
Q

What is the role of gadolinium contrast in MRI imaging?

A

Enhances vasculature and pathologically vascular tissues (e.g. metastases, meningiomas)

37
Q

What is STIR imaging used for in spinal MRI?

A

Short Tau Inversion Recovery - nullifies the fat signal, helping to highlight soft tissue abnormalities like inflammation or oedema

38
Q

What is FLAIR imaging used for in spinal MRI?

A

Fluid Attenuated Inversion Recovery - nullifies CSF signal making it useful for identifying lesions in the brain and spine

39
Q

What is a lytic lesion and how is it seen on MRI?

A

A lytic lesion is a decrease in bone density, appearing as a high-signal area on MRI scans and low signal on CT scans

40
Q

What is a sclerotic lesion and how does it appear on MRI?

A

A sclerotic lesion is an area of increased bone density, appearing as a low-signal area on MRI scans and high-signal on CT scans

41
Q

When should MRI be considered in the diagnosis of low back pain?

A

When there are ‘red flag’ symptoms such as severe neurological deficit, urinary incontinence/retention, significant trauma or suspicion of cancer or infection

42
Q

What is the first line treatment for acute low back pain?

A

Rest, activity modification, pain relief (e.g. NSAIDs) and physical therapy exercises

43
Q

When should opioids be considered for treatment of low back pain?

A

Opioids should only be considered when other treatments fail, and for the shortest duration possible

44
Q

How does physical inactivity contribute to low back pain?

A

Can lead to weakened muscles, poor posture and decreased flexibility which all contribute to increased strain on the back

45
Q

What role does obesity play in the development of low back pain?

A

Obesity increases stress on the spine and muscles, leading to a higher risk of developing low back pain, especially through mechanical overload

Pre-clinical (3 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions