The Spine Flashcards
is most back pain self-limiting?
yes
cardinal rules of back pain management
image early educate reassure avoid bedrest continue movement
red flags of back pain
age <20 and >55
non-mechanical, constant
history of cancer, steroids, HIV, immunocompromised
systemic symptoms e.g. malaise, fever, weight loss
structural deformity
saddle anaesthesia
severe pain for >6 weeks
yellow flags of back pain
low mood high level pain/disability belief that activity is harmful obesity secondary gain (compensation)
what is mechanical back pain?
back pain that is worse with movement and relieved by rest
causes of mechanical back pain
obesity
poor posture
poor lifting technique
lack of exercise
management of mechanical back pain
analgesia and reassure
physiotherapy
what is spondylosis
spinal osteoarthritis
why does spondylosis happen in the elderly?
intervertebral discs lose water content leading to wear and tear and overload at facet joints
what is a severe fracture that can happen in osteoporosis?
crush fractures of the vertebral body
presentation of spondylosis
pain worse with extension
cervical spine= stiffness and pain in neck which radiates to shoulder and occiput
diagnosis of spondylosis
MRI
management of spondylosis
facet joint injections
localised fusion if one or two segments affected
what is an acute disc tear?
acute tear in annulus fibrosis
where are acute disc tears most common?
L4/5
L5/S1