Lower Back Pain Flashcards
What is seen in cauda equina syndrome?
Bilateral sciatica
Urinary incontinence
Decreased anal tone
Loss of perianal sensation
What is seen in abdominal aortic aneurysm?
Age over 60
Pulsating abdominal mass
Pain in back when at rest
What are red-flags for a spinal malignancy?
Pain worsening at night/rest
Over 50yo
Unintentional weight loss
History of malignancy
What are red-flag symptoms of spinal infection?
Fever/Chills Recent infection Immunosuppression IV drug use Dental status History of foreign travel
In which timeframe do most cases of back pain resolve?
4-6 weeks.
Is x-ray useful in back pain?
No, as it does not rule out any serious pathology.
What tests are performed in back pain that does not resolve after 4-6 weeks?
Imaging
FBC
Inflammatory markers
Which form of imaging is gold standard in those with red-flag symptoms?
MRI scan
Is bed rest advised in those with back pain?
No, advise exercise instead.
How is back pain treated?
Give NSAIDs.
In severe cases, opiates may be needed.
What is the most effective prevention method for lower back pain?
Physical activity.
What can nerve root compression result from?
Disc prolapse
Which muscle is closely linked to the sciatic nerve?
The piriformis muscle.
Name 3 spinal tracts
DCML
Corticospinal
Spinothalamic
What are potential causes of an acute spinal cord compression?
Trauma
Infection
Abscess
Haemorrhage
What are potential causes of a chronic spinal cord compression?
Degenerative disease
Tumour
Does cord transection affect sensory or motor function?
It affects both.
It is the most severe spinal injury.
What paralysis is seen in those with a cord transection?
Flaccid areflexic paralysis
What sort of injury is responsible for Brown-Sequard syndrome?
Hemisection of the spinal cord.
What is central cord syndrome?
Incomplete spinal cord injury, characterised by the impairment of the limbs.
What is the cause of central cord syndrome?
Hyperflexion/extension injury of an already stenotic neck.
It is more common in the upper limbs.
Do UMN signs or LMN signs predominate in chronic spinal cord compression?
UMN signs predominate.
In early spinal cord metastasis, what is given to reduce oedema?
Dexamethasone
What is suspected if the disc is intact but bone is destroyed?
Malignancy
What is suspected if the disc is destroyed but bone is intact?
Infection
Does spinal cord decompression reverse injury?
No, it only prevents further worsening of symptoms.
