Week 2: LBP and Lumbar Flashcards

1
Q

What happens to the IV disc during flexion

A

Discs move posteriorly

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2
Q

What happens to the IV disc during extension

A

Discs move anteriorly

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3
Q

What happens to the IV disc during rotation

A

discs mash

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4
Q

Is back pain a symptom or a condition

A

Symptom

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5
Q

The source of low back pain is unknown for what percent of cases?

A

90% of low back cases have unknown pathophysiology

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6
Q

For acute low back pain, in 6 weeks what percent of patients had recovered?

A

60% –> improves by itself, good natural history

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7
Q

Risk factors for non-specific low back pain

A

Heavy and frequent lifting (>25kg)
Obesity, smoking, depressive symptoms

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8
Q

TUNAFISH Red Flags Analogy

A

Trauma
Unexplained weight loss
Neurologic symptoms
Age >50
Fever
Intravenous drug use
Steroid use
History of cancer

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9
Q

Lumbar Stenosis signs and symptoms

A

Bilateral buttock pain, thigh or leg pain, older age
Aggravated by longer walking and released by sitting or flexing

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10
Q

Cook clinical decision rule for lumbar stenosis

A

age >48 years
Bilateral symptoms
Leg pain more than back pain
Pain during walking/standing
Pain relief upon sitting

At least 3/5 positive

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11
Q

Revel’s criteria for low back pain caused by Facet joint

A

Age >65
Forward flexion
extension
Pain well relieved by recumbency
no exacerbation of pain with coughing and sneezing
rising from flexion
extension rotation test

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12
Q

Main components of non-specific LBP management

A

education and reassurance
analgesics
non-pharmacological therapies (exercise, manual therapy, massage, acupuncture)

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13
Q

Main groups in LBP

A

Non-specific pathology (90-95%)
Serious pathology (<1%)
Specific pathology (5-10%)

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14
Q

Serious pathology conditions

A

Malignancies
Systemic inflammatory disorders
Infections
Cauda equina syndrome

Based on clinical examination, medical investigation

Leads to medical management

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15
Q

Specific pathology conditions

A

Fracture (traumatic/stress)
Disc prolapse with radicular pain
Type 1 Modic changes
Sponylolisthesis
Radicular pain
Spinal stenosis

Radiological imaging

Leads to medical management

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16
Q

What is spinal stenosis and how do you diagnose it?

A

Spinal stenosis is the narrowing of the spinal canal leading to nerve compression

Diagnosed based on symptoms like bilateral leg pain, pain relief when bending forward, and confirmed by imaging showing narrowing of the spinal canal

17
Q

Main prognostic factors of LBP

A

higher disability
presence of sciatica
older age
poor general health
increased psychological or psychosocial distress
negative cognitive characteristics
poor relationships with colleagues
heavy physical work demands

18
Q

Typical words used in patient interview and observation suggestive of non-specific LBP

A

Stiffness
Pain comes and goes
worse/better with certain movements
flare ups
no specific trauma, activity or mechanism
postural related (lots of sitting/standing)

19
Q

Reasons for PAIVMs

A

Improved ROM
Decrease in pain/stiffness
improved QoL
Patient preference