Mechanical Back Pain

Question 1

what are the causes of backspin?

Answer 1

viscerogenic
spondylogenic
discogenic
neurogenic
psychogenic

Question 2

name a viscerogenic cause of backpain.

Answer 2

AAA
peptic ulcer
gallbladder
kidney
liver etc

Question 3

what are the 3 things present in a back history?

Answer 3

back pain
leg pain
neurological symptoms

Question 4

what are the 3 clinical presentations of back pain?

Answer 4

PSP - possible spinal pathology

NRP - nerve root problems

MBP - mechanical back pain

Question 5

Where is the common location of back pain?

Answer 5

lumbar/thoracic region

Question 6

what types of onset of back pain are there?

Answer 6

sudden
gradual
insidious

Question 7

what is the natures of back pain?

Answer 7

sharp
shooting
dull

Question 8

leg pain can either be ________ or ____

Answer 8

referred or root

Question 9

what type of pain is referred leg pan?

Answer 9

dull
buttock/thigh
rare below knee
ill definied

Question 10

what type of pain is root leg pan?

Answer 10

sharp/shooting/electric
below knee to ankle
anatomical sensory
SCIATICA

Question 11

what are the neurological symptoms in back pain?

Answer 11

bowel/urinary

incontinence
loss of control
perianal - saddle anaesthesia
bilateral or unilateral

Question 12

what additional information is useful in the history?

Answer 12

age and occupation

litigation

Question 13

what are the red flags in back pain?

Answer 13

systemic upset

saddle anaesthesia +/- bladder or bowel upset

Question 14

name some possible spinal pathologies (4)

Answer 14

osteoporosis in spine causing fracture

tumours - metastatic

infection

inflammatory - ankylosing spondylitis

Question 15

what are the 5 cancers that spread to bone?

Answer 15

breast
bronchus
prostate
thyroid
kidney
(adenocarcinoma of lung)

Question 16

what are the causes of nerve root problems in back pain?

Answer 16

disc prolapse

Question 17

what is the pathogenesis of disc prolapse?

Answer 17

impaired disc nutrition
disc prone to damage
disc fissure
protrusion, extrusion, sequestrated

either small or large vertebral canal

loss of disc height
facet arthropathy

back pain (+/- canal stenosis)

Question 18

what are the 2 types of vertebral canal?

Answer 18

large and small

Question 19

outline the large vertebral canal

Answer 19

back pain from stretched annulus/post long ligament

Question 20

outline the small vertebral canal

Answer 20

root compression
inflammatory mediators
root pain and tension signs
resolution/surgery

Question 21

when do you diagnose mechanical back pain?

Answer 21

diagnosis of exclusion

most common

Question 22

Paris interacularis looks like what on x-ray?

Answer 22

scotty dog

Question 23

name the myotomes in:

hip flexion
knee extension
foot dorsiflexion & EHL
ankle plantarflexion

Answer 23

hip flexion - L1/2
knee extension - L3/4
foot dorsiflexion & EHL - L5
ankle plantarflexion - S1/2

Question 24

what must you not forget to examine in someone with back ache?

Answer 24

abdominal exam and PR

Question 25

what does the schober’s method measure?

Answer 25

spinal flexion