Managing Back Pain in Primary Care

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Questions and Answers

Match the following imaging techniques with their ability to detect specific spinal conditions:

X-rays = Not recommended for most patients with low back pain MRI = More sensitive than plain films for detecting spinal infections, cancers, herniated disks, and spinal stenosis CT = More sensitive than plain films for detecting spinal infections, cancers, herniated disks, and spinal stenosis Plain films = Less sensitive than MRI and CT for detecting spinal infections, cancers, herniated disks, and spinal stenosis

Match the following management approaches with their recommended duration for bed rest:

Mechanical low back pain = Bed rest not generally recommended unless pain is severe enough to preclude normal activities; if needed, limited to 2 to 3 days Non-mechanical causes of low back pain = Bed rest not generally recommended unless pain is severe enough to preclude normal activities; if needed, limited to 2 to 3 days Acute phase of low back pain = Bed rest not generally recommended unless pain is severe enough to preclude normal activities; if needed, limited to 2 to 3 days Chronic low back pain = Bed rest not generally recommended unless pain is severe enough to preclude normal activities; if needed, limited to 2 to 3 days

Match the following pharmacological treatments with their cautions or considerations:

NSAIDs = Cautious use in patients with a history of gastritis, asthma, hypertension, chronic renal failure, or CHF Muscle relaxants = Consideration based on pain severity Opioid therapy = Consideration for short course if pain is severe Traction and analgesic injection = Usually not helpful in the acute stage of low back pain

Match the following surgical treatment indications with their associated low back pain conditions:

Cauda equina syndrome and worsening neurologic deficits = Indicative of potential benefit from surgery if conservative care fails Herniated disks and spinal stenosis = Indicative of potential benefit from surgery if conservative care fails Disabling symptoms without response to conservative care = Indicative of potential benefit from surgery if conservative care fails Fractures and infection = Not specifically mentioned as indicative of potential benefit from surgery if conservative care fails Signup and view all the answers

Match the following urgent/emergency referrals with their corresponding low back pain conditions:

Cauda equina and severe radiculopathy = Urgent/Emergency referrals Fractures and recalcitrant spinal canal stenosis = Other referrals Neoplasia or infection and undiagnosed back pain = Other referrals Continuing pain of 3 months’ duration without a clearly definable cause and erectile dysfunction = Other referrals Signup and view all the answers

Match the following prevention and education tips with their corresponding back care advice:

Losing weight = Preventive measure for strain on the lower back Posture while sitting, standing, and lying down = Tips for maintaining good posture to support the back Lifting and carrying techniques = Guidelines for preventing back injury while handling objects Exercise recommendations = Advice for improving core muscle strength that supports the back Signup and view all the answers

Match the following back pain characteristics with their corresponding types:

Can feel better or worse based on position, typically worsens with movement = Mechanical back pain Age at onset of back pain: 3 months = Inflammation-related back pain Characterized by radicular pain (pain that radiates into the lower extremity directly along the course of a spinal nerve root) = Root nerve compression Most cases occur in patients older than 50 years = Malignancy-related back pain Signup and view all the answers

Match the following back pain examination techniques with their descriptions:

Palpation of spine processes, para-vertebral muscles, and sacroiliac joint = Physical examination for back pain Range of motion testing in flexion, extension, lateral bending, and rotation = Physical examination for back pain Special tests like the straight-leg raise and Patrick’s test (FABER) = Physical examination for back pain Inspection of the back for scoliosis, lordosis, swelling, scars, and muscle wasting = Physical examination for back pain Signup and view all the answers

Match the following back pain cases with their corresponding patient descriptions:

38-year-old man with acute low back pain after lifting boxes = Case 1 20-year-old man with chronic low back pain and stiffness = Case 2 9-year-old male patient with severe lower back pain and radicular right leg pain = Case 3 78-year-old man with new onset low back pain and metastatic prostate cancer = Case 4 Signup and view all the answers

Match the following symptoms with their corresponding indications for investigations:

Progressive neurological findings = Indications for investigations Constitutional symptoms = Indications for investigations History of traumatic onset = Indications for investigations History of malignancy = Indications for investigations Signup and view all the answers

Match the following risk factors with their corresponding investigations:

Infectious risk such as injection drug use = Indications for investigations Immunosuppression = Indications for investigations Indwelling urinary catheter = Indications for investigations Prolonged steroid use = Indications for investigations Signup and view all the answers

Match the following durations of back pain with their corresponding time frames:

Acute pain = Less than 6 weeks Subacute pain = 6 – 12 weeks Chronic pain = More than 12 weeks Constant pain = Uninterrupted Signup and view all the answers

Match the following risk factors with their association to back pain:

Smoking = Risk factor for back pain Obesity = Risk factor for back pain Older age = Risk factor for back pain Physically strenuous work = Risk factor for back pain Signup and view all the answers

Match the following components of history taking with their corresponding categories:

Personal Data = Category of history taking SOCRATES = Category of history taking Red Flags = Category of history taking PMH Hx = Category of history taking Signup and view all the answers

Match the following psychological factors with their association to back pain:

Somatization disorder = Psychological factor associated with back pain Anxiety = Psychological factor associated with back pain Depression = Psychological factor associated with back pain PTSD = Psychological factor associated with back pain Signup and view all the answers

Match the following elements of SOCRATES with their descriptions:

Site = Element of SOCRATES Onset = Element of SOCRATES Exacerbating = Element of SOCRATES Radiation = Element of SOCRATES Signup and view all the answers

Match the following past medical history factors with their relevance to back pain:

Trauma = Relevance to back pain in past medical history Cancer = Relevance to back pain in past medical history Osteoporosis = Relevance to back pain in past medical history Diabetes mellitus = Relevance to back pain in past medical history Signup and view all the answers

Match the following medication categories with their potential impact on back pain:

Psychotic medications = Impact on back pain Steroids = Impact on back pain NSAIDs = Impact on back pain Antibiotics = Impact on back pain Signup and view all the answers

Match the following family and social factors with their relevance to back pain:

Inherited disease = Relevance to back pain in family and social factors Smoking habits = Relevance to back pain in family and social factors Alcohol consumption = Relevance to back pain in family and social factors Dietary habits = Relevance to back pain in family and social factors Signup and view all the answers

Match the following types of back pain with their corresponding locations:

Lumbosacral area = Location of common type of back pain Thoracic spine region = Location of common type of back pain Cervical spine region = Location of common type of back pain Sacral region = Location of common type of back pain Signup and view all the answers

Match the following types of work with their association to risk of developing back pain:

Physically strenuous work = + Risk of developing back pain Sedentary work = - Risk of developing back pain Manual labor work = + Risk of developing back pain Office-based work = - Risk of developing back pain Signup and view all the answers