low back pain

Question 1

6 major anatomical parts of spine

Answer 1

1. bones
2. nerves
3. muscles - intrinsic and extrinsic
4. discs
5. facet joints - 2 for each movement
6. ligaments

Question 2

non-modifiable risk factors for LBP (9)

Answer 2

1. M=F
2. increases with age
3. prior back pain
4. low educ.
5. higher intensity/disability
6. neuro Sx
7. depress
8. anx
   9 somatizations

Question 3

6 modifiable risk for LBP

Answer 3

1. BMI
2. smoking
3. poor anerobic endurance
4. ergonomic factors
5. job
   6 litigation

Question 4

length of types of LBP

Answer 4

acute - 12

Question 5

main causes of LBP

Answer 5

80-90% mech
5-15 - neuro
1-2 - non-mech spinal
1-2 visceral
2-4 other

Question 6

7 parts to evaluation

Answer 6

1. Hx
2. red flags
3. pain diagram
4. psych assess
5. functional assess
6. physcical exam
7. imaging

Question 7

breakdown of 4 main types

Answer 7

Leg dom - constant or intermittent

Back dom - constant or intermittent

Question 8

5 key questions

Answer 8

1. where is pain the worst
2. constant/intermittent
3. hurt with flexion
4. any loss of bladder/bowel
5. stiffness > 30 min in AM

Question 9

5 red flags

Answer 9

1. neurological problems
2. infection
3. fracture
4. tumour
5. infammation

Question 10

7 yellow flags

Answer 10

1. beleif that act. makes worse
2. relaince on rest/inactivity
3. persistent low mood
4. belief that passive treatment is key
5. work problems
6. bad family dynamic
7. pain catastrophizing

Question 11

part of functional assessment

Answer 11

• work
• ADL, iADLs
• leisure, sex,

Question 12

minimum for PHx

Answer 12

• movement testing flexion
• movement testing extension
• patellar reflex
• great toe flex and ext. power
• plantar response
• passive leg raise
• saddle sensation

Question 13

what is guide for imaging

Answer 13

no CT, x-ray, or MRI unless red flags

Question 14

3 parts to smart goal setting

Answer 14

1. what about pain worries the most
2. what can you do to imrove pain
3. how confident are you that you can improve pain

Question 15

what does SMART stand for

Answer 15

Specific
Measurable
Attainable
Relevant
Time based

Question 16

2 key core exercises and testing

Answer 16

1. prone bridge

2. supine brdge

Question 17

5 key messages to communicate to patient patient

Answer 17

1. there are no red flags
2. imaging is not helpful
3. low back pain often recurs
4. you may need pain meds, but excercise is what will help you recover
5. if you feel sad or anxious it could be from pain and inhibit recovers

Question 18

self care Tx for LBP (3)

Answer 18

1. remain active
2. books
3. heat - acute only

Question 19

pharma Tx for LBP (5)

Answer 19

1. aceto
2. NSAIDS
3. muscle relaxants - acute only
4. benzos
5. anti -dep - chronic only

Question 20

8 non-pharma Tx

Answer 20

1. spinal manipulation
the rest are only for chronic
2. excercise
3. massage
4. acupuncture
5. yoga
6. CBT
7 relaxation