Lower Back Pain Flashcards
General Red Flag symptoms
Failure to improve after 4-6 weeks of therapy
Unrelenting night pain
Pain at rest
Progressive motor or sensory defect
What are some red flags that indicate cancer could be a cause?
Age >50
Unintended weight loss
History of cancer
Pain at night or in recumbency
What are some red flags that could indicate an infection?
Fever Chills Recent infection Immunosuppression IV drug use Foreign travel Poor dental health
What are some indicators the pain could be from a fracture?
Age >50
Osteoporosis
Trauma
Chronic steroid use
What are some indicators it could be Cauda Equina Syndrome?
Bilateral sciatica Saddle Paraesthesia Urinary incontinence Leg weakness Decreased anal tone
What are some indicators it could be a AAA?
Age >60
Abdominal Pulsating Mass
Pain at rest
history of drinking and smoking
When is a Plain X Ray used?
Young man to check for Ankylosing Spondylitis in SI joint
Elderly to check for vertebral collapse
When is a CT used?
Where MRI is contraindicated
Foreign body, Trauma, Implant
When is an MRI used?
Good for soft tissues
Red flag neurological symptoms
When is a radionucleotide bone scan used?
Shows an increased bone turnover
What conditions would show an increased bone turnover?
Fractures Osteomyelitis Pagets Metastesis Ankylosing Spondylitis
When are SPECT or PET scans used?
Suspected Metastatic disease
In metabolic causes of back pain what substances are unusual in the laboratory tests?
Alkaline Phosphatase
Ca2+
PO4+
In metastatic causes what abnormalities would show up in the labatory tests?
PSA
Acid phosphatase
What is the baseline of pharmacological treatment in lower back pain?
NSAIDs to enable mobility
