Prolapsed Intervertebral Discs and Mechanical Back Pain Flashcards
neurological symptoms of back pain?
numbness
paraesthesia
weakness
temperature disturbance
social factors to cover in an ortho history?
support housing job lifestyle capacity to do things
red flag features of back pain history?
non-mechanical pain systemic involvement new major neuro deficit saddle anaesthesia bladder/bowel upset pain at night
what are you looking for on examination of the back
deformity asymmetry hairy patches neurofibromata muscle spasm check normal curvature of spine
normal finding on schobers test?
21cm
what finding is indicative of a pathological schobers test?
<18 cm
what schobers finding indicates a hypermobile patient
> 24cm
how can you test for nerve irritation?
straight leg test
sciatic stretch test
bowstring test
which position is the femoral stretch test best done?
on the patients side
clinical signs shown by the patient that may indicate theyre in pain?
guarding
bracing
rubbing
sighing
are x rays useful in back pain?
no - usually just show degenerative damage that isn’t the cause of pathology
good investigation for spinal stenosis?
x ray
clinical presentation of spinal stenosis on x ray?
degenerate, hypertrophic facet joints and spine with narrow interpedicular distance and obliteration of neural foramina
main first line investigation for back pain?
MRI
what to watch out for with MRI?
false positives - shows other damage that doesnt relate to the pathology
