lower back pain

Question 1

what are red flags for lower back pain?

Answer 1

<20 or >50yo
hx previous malignancy
night pain
hx trauma
systemically unwell eg weight loss, fever

Question 2

what are some causes of lower back pain that affect the facet joints + pain is worse in morning + standing, worse on extension of back?

Answer 2

spinal stenosis
ankylosing spondylitis
peripheral arterial disease

Question 3

describe features of spinal stenosis

Answer 3

gradual onset
uni or bilateral leg pain- with or without back pain
numbness + weakness worse on walking
resolves when sitting down or leaning forwards/crouching down
aching/crawling
exam is often normal

Question 4

describe features of ankylosing spondylitis

Answer 4

young man with lower back pain + stiffness
worse in morning
improves with activity
peripheral arthritis

Question 5

describe features of peripheral arterial disease

Answer 5

pain on walking
relieved by rest
absent or weak foot pulses + other signs of limb ischaemia
past history- smoking/vascular diseases