Low back pain sl

Question 1

pts with nonmechanical back pain typically have

Answer 1

pain both at rest and with movement

usu due to chemical irritation from inflam or infection

Question 2

differential diagnosis for lower back pain

Answer 2

table 36.1 p 438

Question 3

lumbar strain or sprain can radiate into

Answer 3

buttocks or proximal lower extremities

Question 4

pain that evolves slowly is more likely

Answer 4

a degenerative process such as spinal stenosis or rheumatologic process like ankylosing spondylitis

Question 5

pain that’s acute is more likely

Answer 5

disk problem or muscle strain

Question 6

chronic dull pain may increase probability of

Answer 6

cancer

Question 7

location of pain

Answer 7

lumbar strain–paraspinous muscles

mestastatic dis or a compression frac—spine

radiating below knee—herniated disk

cauda equina syn—saddle anesth, bilateral leg pains

spinal stenosis—radiates into legs

Question 8

red flags for low back pain

Answer 8

p 442

Question 9

leg pain from spinal stenosis is often called

Answer 9

pseudoclaudication or neurogenic claudication because the symptoms tend to worsen with exercise

due to narrowing of the sp canal causing radicular impingement

Question 10

spinal stenosis pts have more pain doing what

Answer 10

extension of the spine—so going downhill or down stairs

Question 11

basic PE for lower back pain includes

Answer 11

assessing range of motion of lumbar spine
palpation and inspection of spinous processes and paraspinous muscles

assessing motor strength , deep tendon reflexes in lower extremities

straight leg raise test

assess motor strength of dorsiflexion and extension of great toe (herniated disk)

Question 12

XRs are useful to identify

Answer 12

compression fractures and degen changes of spine

Question 13

risk factors for low back pain

Answer 13

hx of back pain
heavy lifting
frequent bending
twisting and lifting
repetitive work with exposure to vibration
psychosocial issues