clinical approach to back pain Flashcards Preview

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Flashcards in clinical approach to back pain Deck (10):
1

where is hip disease referred to?

The knee

2

where is diaphragmatic irritation referred to?

the shoulder

3

what Is the definition of mechanical back pain?

Pain secondary to overuse of a normal anatomical structure or pain secondary to trauma or deformity of an anatomical structure

4

what are clinical features of mechanical back pain?

Otherwise well
age 20-55
varies with posture and activity

5

what are clinical features of nerve root tension causing back pain?

unilateral leg pain> back pain
radiation to below knees
numbness and parathesia
signs of nerve irritability
motor, sensory and reflex changes

6

what are clinical features of inflammatory back pain?

- more common in mals
- slow onset of symptom
- chronic
- morning stiffness that gets better with activity
- usually the axial skeleton
- extraskeletal features such as uveitis, CVS

7

what clinical features can indicate serious spinal pathology?

constant, progressive and non mechanical
systemic symptoms of weight loss and unwell
- widespread nerve root signs
sphincter problems

8

what is the general management of inflammatory back pain?

- education
- NSAIDS
disease modifying drugs (methotrexate, sulphasalazine)

9

what do you not offer in the NHS for back pain?

imaging in a non specialist setting
belt/corset orthotics
acupuncture
spinal injections
electrotherapy

10

what medications do you not offer for back pain according to NICE guidelines?

SSRI's
anticonvulsants
disk replacement
Opioids not for chronic back pain