Osteoarthritis and Low Back Pain Management
48 Questions
0 Views

Choose a study mode

Play Quiz
Study Flashcards
Spaced Repetition
Chat to Lesson

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

What is the first-line drug treatment recommended for osteoarthritis?

  • Regular paracetamol (correct)
  • Opioids
  • Low-dose antidepressants
  • Topical NSAIDs

Which of the following multidisciplinary team members would you refer to for foot care and insoles?

  • Physiotherapist
  • Chiropodist (correct)
  • Occupational Therapist
  • Social Worker

Which self-management strategy can help alleviate symptoms of knee osteoarthritis?

  • Avoiding physical activity
  • Weight reduction (correct)
  • Increased sugar intake
  • Prolonged bed rest

What should be co-prescribed with NSAIDs for patients taking them for more than one week?

<p>Proton pump inhibitors (C)</p> Signup and view all the answers

Which type of exercises are particularly recommended for patients with limited mobility due to osteoarthritis?

<p>Isometric exercises (B)</p> Signup and view all the answers

What is an effective method for managing pain in osteoarthritis before considering medications?

<p>Local heat/cold treatments (C)</p> Signup and view all the answers

Which option is a commonly used topical treatment for knee and hand osteoarthritis?

<p>Capsaicin cream (C)</p> Signup and view all the answers

What lifestyle modification can improve outcomes for patients with hip osteoarthritis?

<p>Using a walking stick in the opposite hand (D)</p> Signup and view all the answers

What characterizes acute low back pain?

<p>A new episode lasting less than 3 months (D)</p> Signup and view all the answers

Which symptom suggests that low back pain may be inflammatory in nature?

<p>Pain easing with movement (A)</p> Signup and view all the answers

What aspect should be excluded when evaluating back pain?

<p>Pain originating from gastrointestinal issues (A)</p> Signup and view all the answers

When examining a patient for low back pain, which finding indicates potential inflammation?

<p>Palpable tenderness over the spine (D)</p> Signup and view all the answers

Which sign is typically tested with a straight leg raise (SLR) during physical examination?

<p>Sciatica (A)</p> Signup and view all the answers

What should be assessed to evaluate severity during a back pain examination?

<p>Ability to lie down comfortably (D)</p> Signup and view all the answers

Which of the following is NOT a history detail that should be collected for low back pain?

<p>Family history of COPD (D)</p> Signup and view all the answers

What kind of deformity is typically found in ankylosing spondylitis?

<p>Kyphosis (B)</p> Signup and view all the answers

What is the most significant reason that patients with osteoarthritis seek medical help?

<p>Pain (B)</p> Signup and view all the answers

Which factors influence the level of pain and disability experienced by patients with osteoarthritis?

<p>Personality and mental health (D)</p> Signup and view all the answers

Which joints are most commonly affected by osteoarthritis?

<p>Hips, knees, and base of the thumb (D)</p> Signup and view all the answers

What is a common familial tendency associated with nodal osteoarthritis?

<p>Swelling of the distal interphalangeal joints (Heberden’s nodes) (C)</p> Signup and view all the answers

How is osteoarthritis classified in terms of its underlying process?

<p>A metabolically active process involving the whole joint (B)</p> Signup and view all the answers

Which of the following factors is NOT a recognized risk factor for osteoarthritis?

<p>Excessive physical activity (A)</p> Signup and view all the answers

What might investigations such as X-rays reveal in a patient with osteoarthritis?

<p>Osteophytes and subchondral bone sclerosis (B)</p> Signup and view all the answers

What does the management of osteoarthritis in primary care typically involve?

<p>A holistic approach (A)</p> Signup and view all the answers

What is a recommended course of action for patients considering steroid treatments for osteoarthritis?

<p>Consider a trial of a single long-acting steroid injection. (A)</p> Signup and view all the answers

Which complementary therapy is widely reported to be used by osteoarthritis sufferers but is generally not recommended?

<p>Hyaluronic acid knee injections (C)</p> Signup and view all the answers

What is the main reason for referring a patient suspected of rheumatoid arthritis to rheumatology?

<p>For early treatment with disease-modifying drugs. (D)</p> Signup and view all the answers

Which of the following has shown limited effectiveness in treating conditions other than back pain?

<p>Chiropractic therapy (C)</p> Signup and view all the answers

What is a common psychological factor affecting patients with osteoarthritis?

<p>Depression and anxiety (B)</p> Signup and view all the answers

What is the controversy surrounding the use of glucosamine in osteoarthritis management?

<p>Its impact on OA progression is unclear. (C)</p> Signup and view all the answers

What should practitioners ensure when advising patients about complementary therapies?

<p>That the practitioner has accredited training and professional indemnity insurance. (C)</p> Signup and view all the answers

For which condition should patients with severe osteoarthritis symptoms potentially be referred to orthopedic specialists?

<p>Joint sepsis suspected (D)</p> Signup and view all the answers

What is a common feature of the hands in rheumatoid arthritis?

<p>Ulnar deviation of the fingers (B)</p> Signup and view all the answers

Which deformities are characteristic of the thumb in rheumatoid arthritis?

<p>Z deformity and Boutonnière deformity (B)</p> Signup and view all the answers

What condition may develop in the knee area of patients with rheumatoid arthritis?

<p>Baker’s cyst (D)</p> Signup and view all the answers

What complications might arise from cervical spine involvement in rheumatoid arthritis?

<p>Cord compression from atlanto-axial instability (D)</p> Signup and view all the answers

What is a feature associated with Felty’s syndrome in rheumatoid arthritis patients?

<p>Recurrent infections and splenomegaly (D)</p> Signup and view all the answers

What non-articular manifestation is commonly seen in patients with rheumatoid arthritis?

<p>Pleural effusions and pulmonary nodules (C)</p> Signup and view all the answers

What role does C-reactive protein (CRP) play in the assessment of rheumatoid arthritis?

<p>Acts as a marker for acute inflammation (B)</p> Signup and view all the answers

Which of the following is NOT increased by rheumatoid arthritis?

<p>Grip strength (B)</p> Signup and view all the answers

What is the most common joint affected during an acute gout attack?

<p>Big toe (B)</p> Signup and view all the answers

Which of the following conditions is a risk factor for developing gout?

<p>Obesity (A)</p> Signup and view all the answers

What type of crystals are typically found in the synovial fluid of a gout patient?

<p>Sodium monourate (B)</p> Signup and view all the answers

Which imaging finding might indicate chronic gout?

<p>Erosive pattern of the joint (D)</p> Signup and view all the answers

Which of the following best describes the clinical presentation of chronic gout?

<p>Recurrent acute attacks and tophi formation (A)</p> Signup and view all the answers

In the context of gout, what can trigger acute attacks?

<p>Acute infections (A)</p> Signup and view all the answers

What is the primary cause of calcium pyrophosphate deposition disease (CPPD)?

<p>Pyrophosphate crystal deposition (A)</p> Signup and view all the answers

How may calcium pyrophosphate deposition disease present on X-ray?

<p>Chondrocalcinosis (D)</p> Signup and view all the answers

Flashcards

Acute low back pain

A new episode of low back pain lasting less than 3 months.

Mechanical low back pain

Pain that comes and goes, often related to movement, and usually eases with rest.

Inflammatory low back pain

Pain that is constant and severe, often worse at night and with rest, suggesting inflammation in the spine.

Loss of lumbar lordosis

A loss of the natural inward curve of the lower back.

Signup and view all the flashcards

Kyphosis

A hunchback posture, commonly seen in ankylosing spondylitis.

Signup and view all the flashcards

Scoliosis

A sideways curvature of the spine, which can be associated with low back pain.

Signup and view all the flashcards

Straight leg raise (SLR)

A test to check for sciatica by raising one leg while lying down, which can elicit pain in the back, buttock, or leg.

Signup and view all the flashcards

Sciatica

Pain radiating down the leg, commonly caused by compression or inflammation of the sciatic nerve.

Signup and view all the flashcards

Osteoarthritis

The most common cause of locomotor disability. It used to be considered 'wear and tear' on the bone/cartilage of synovial joints, but is now recognized as a metabolically active process involving the whole joint.

Signup and view all the flashcards

Abnormal mechanical loading of joint

A risk factor for osteoarthritis, often due to instability or excess stress on the joint.

Signup and view all the flashcards

Crepitus

A common sign of osteoarthritis, meaning a grating or crackling sound in the joint.

Signup and view all the flashcards

Nodal OA

A type of osteoarthritis characterized by swelling of the distal interphalangeal joints, commonly affecting the hands.

Signup and view all the flashcards

Decreased joint space

A finding on X-ray indicating osteoarthritis, meaning a reduction in the space between the bones of a joint.

Signup and view all the flashcards

Osteophytes

A common finding on X-ray indicating osteoarthritis, meaning the appearance of bony growths along the edges of joints.

Signup and view all the flashcards

ESR (Erythrocyte Sedimentation Rate)

A test used to exclude inflammatory arthritis, where an elevated ESR (>30mm/h) may suggest another condition.

Signup and view all the flashcards

Holistic approach to OA management

A holistic approach to treating osteoarthritis, focusing on various aspects beyond just medication.

Signup and view all the flashcards

Assess OA's effect on functioning

Impact of OA on daily life, including work, mood, relationships, and hobbies.

Signup and view all the flashcards

Create an OA management plan

A personalized plan to manage OA, including patient-led strategies, addressing co-existing conditions, and regular check-ups.

Signup and view all the flashcards

Provide OA education

Information and advice given to patients about OA, covering symptoms, treatment options, and helpful resources.

Signup and view all the flashcards

Weight reduction for OA

Reducing weight to ease OA symptoms and slow down joint damage, especially in knee OA.

Signup and view all the flashcards

Exercise for OA

Exercises for strengthening muscles around joints, aiding in pain management and improving function.

Signup and view all the flashcards

Paracetamol for OA

First-line drug treatment for all OA, commonly used in combination with non-pharmacological approaches.

Signup and view all the flashcards

Topical NSAIDs for OA

NSAIDs that are applied directly to the skin, often preferred for knee and hand OA due to fewer side effects.

Signup and view all the flashcards

Opioids for OA

A type of medication used to manage OA pain, typically as a second-line option after paracetamol and topical NSAIDs.

Signup and view all the flashcards

What is rheumatoid arthritis (RA)?

The most common disorder of connective tissue, affecting around 71% of the UK population. It is an immune system related disease, triggered by environmental factors in people with a genetic predisposition.

Signup and view all the flashcards

What is the disease course of rheumatoid arthritis like?

Characterized by variable disease course with periods of worsening symptoms (exacerbations) and periods of improvement (remissions).

Signup and view all the flashcards

Why is early intervention important in rheumatoid arthritis?

Early treatment with disease-modifying drugs can significantly alter the progression of RA.

Signup and view all the flashcards

What is the prevalence of CAM in osteoarthritis?

Complementary and alternative medicine (CAM) use is common in people with osteoarthritis. Examples include copper bracelets, acupuncture, food supplements, and dietary changes.

Signup and view all the flashcards

What is the evidence for chiropractic/osteopathy in musculoskeletal problems?

Good evidence suggests that chiropractic and osteopathy can be helpful for back pain. However, evidence for their effectiveness in other areas is limited.

Signup and view all the flashcards

What is glucosamine and its role in osteoarthritis?

Glucosamine is a supplement that is available over-the-counter but not recommended by NICE. The evidence on whether it slows the progression of OA is controversial.

Signup and view all the flashcards

What is strontium ranelate and its role in osteoarthritis?

Strontium ranelate has been shown to slow the progression of OA, decrease pain, and improve mobility. However, its place in OA management is still being determined.

Signup and view all the flashcards

How do psychological factors affect osteoarthritis?

Psychological factors can significantly impact disability from OA. Education about the disease and reassurance that it's not progressive in most people is important. Screening for depression and anxiety is also recommended.

Signup and view all the flashcards

Gout

A medical condition caused by the deposition of uric acid crystals in joints, leading to painful inflammation.

Signup and view all the flashcards

Acute Gout

A condition characterized by recurrent attacks of severe joint pain, typically in the big toe, due to the accumulation of uric acid crystals in the joints.

Signup and view all the flashcards

Hyperuricemia

Elevated levels of uric acid in the blood.

Signup and view all the flashcards

Tophi

Deposits of uric acid crystals in the tissues, often found in the ears, tendons, and joints.

Signup and view all the flashcards

Calcium Pyrophosphate Deposition Disease (CPPD)

A type of arthritis caused by the deposition of calcium pyrophosphate crystals, leading to joint inflammation.

Signup and view all the flashcards

Chondrocalcinosis

Calcification of the articular cartilage, a sign of CPPD.

Signup and view all the flashcards

Knee

The most common joint affected by CPPD.

Signup and view all the flashcards

Chronic CPPD

A chronic form of CPPD often characterized by joint erosion.

Signup and view all the flashcards

Rheumatoid arthritis (RA)

A type of arthritis characterized by inflammation of the lining of the joints, causing pain, stiffness, and swelling.

Signup and view all the flashcards

Ulnar deviation

A deformity of the fingers in RA where the fingers curve towards the little finger, due to joint erosion.

Signup and view all the flashcards

Z-deformity of the thumb

A deformity seen in RA where the thumb bends towards the palm, often accompanied by pain and difficulty gripping objects.

Signup and view all the flashcards

Boutonnière deformity

A deformity in RA where the finger joint closest to the fingernail (DIP) is bent, while the middle joint (PIP) is straightened out.

Signup and view all the flashcards

Baker's cyst

A swelling in the back of the knee, often caused by RA. May rupture and mimic a blood clot.

Signup and view all the flashcards

Sjögren's syndrome

An autoimmune disease that attacks the salivary and tear glands, often occurring with RA, causing dry eyes and mouth.

Signup and view all the flashcards

Vasculitis

Inflammation of the small blood vessels, causing digital infarction (tissue death), ulcers, and nerve damage. A complication of RA.

Signup and view all the flashcards

Felty's syndrome

A combination of RA, enlarged spleen, and low white blood cell count, occurring in patients with long-standing RA. Increases risk of infections.

Signup and view all the flashcards

Study Notes

Musculoskeletal Problems

  • Chapter 14 of the text discusses musculoskeletal problems, covering a range of symptoms and conditions, including neck pain, low back pain, shoulder and elbow problems and more.
  • The text also details various symptoms of musculoskeletal disease, bone disorders, sports medicine, management of sporting injuries, and different types of arthritis (osteoporosis, osteoarthritis, rheumatoid arthritis, etc.).
  • Symptoms of musculoskeletal conditions often include pain, stiffness, and loss of function.
  • Examination of musculoskeletal issues often includes assessments of deformity, tenderness, muscle spasm, range of motion, and neurological function.
  • Management approaches discussed include community triage, analgesic use, and possible specialist referrals based on the patient's history and examination.

Low Back Pain

  • Acute low back pain lasts less than 6 weeks
  • Chronic low back pain lasts longer than 3 months.
  • Prevalence of back pain in a lifetime is 58%.
  • Causes of back pain can be evaluated via history regarding circumstances of pain, nature/severity, associated symptoms, past medical history and excluding pain that isn't spinal.
  • Examination includes assessing deformity, palpation for tenderness, and assessing movement.
  • Patients without specific red flag symptoms might initially be managed with analgesia, avoiding bedrest, promoting activity, and potentially using self-help exercises.

Acute Back Pain

  • History of trauma is a crucial factor in assessing acute back pain.
  • Cauda equina syndrome and rapidly progressive neurological deficit are serious concerns requiring immediate admission.
  • Simple mechanical backache in otherwise healthy individuals may resolve within 4 weeks with conservative management.
  • Assessing "yellow flags" (psychosocial factors that inhibit recovery) is crucial for management.

Scoliosis

  • Lateral curvature of the spine and potential rotation of vertebrae.
  • Early detection and intervention may help prevent complications.

Cauda Equina Syndrome

  • This is a critical neurological emergency
  • Cauda equina syndrome is characterized by bowel and/or bladder dysfunction (incontinence), or lower motor nerve weakness.

Shoulder Problems

  • Shoulder pain can be caused by various factors, including tendinitis, tears, impingement, and dislocations.
  • A "painful arc" can indicate impingement.
  • Shoulder examination assesses posture, tenderness, movement, and range of motion.

Elbow Problems

  • Common elbow problems include tendinopathies, instability, and dislocations.
  • History and examination include assessing pain, stiffness, deformity, and loss of function
  • Treatment for elbow conditions typically involves rest, ice, NSAIDs, and potentially specialized physiotherapy.

Osteoporosis

  • Lifetime risk of osteoporotic fracture is high (>200,000 cases annually in the UK).
  • Osteoporosis is diagnosed via T-score, which compares bone density to an average young adult.
  • Osteoporosis can be either primary (e.g., naturally occurring post-menopause) or secondary (e.g., due to underlying diseases).
  • Management includes lifestyle advice, medication (bisphosphonates, denosumab), and potential considerations for fracture prevention.
  • Treatment options like hormone replacement therapy and other drugs are sometimes considered depending on individual circumstances

Treatment Options for Osteoporosis

  • Lifestyle advice plays a huge role in managing osteoporosis.
  • Adequate nutrition, maintaining a healthy weight, regular exercise, smoking cessation, and limiting alcohol intake are essential.
  • Medications like bisphosphonates, Denosumab and Teriparatide often prescribed to prevent further fracture and/or bone loss.

Rheumatoid Arthritis

  • Rheumatoid arthritis (RA) is an autoimmune disorder primarily affecting the small joints of the hands and feet.
  • Characterized by pain, stiffness, swelling, and inflammation.
  • Early diagnosis and treatment are crucial to managing the disease's progression and prevent irreversible joint damage.

Crystal-Induced Arthritis

  • Conditions like gout and pseudogout are forms of crystal-induced arthritis.
  • Gout typically causes acute, painful attacks in joints, often the big toe.
  • Pseudogout also presents similarly, however, presents with deposits of calcium pyrophosphate crystals in joints.

Further Information

  • Various resources—like specific organisations for arthritis, care, and support—are mentioned in the text for further information or guidance on these conditions.

Studying That Suits You

Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

Quiz Team

Related Documents

MSK GP PDF

Description

This quiz focuses on key treatment strategies and self-management techniques for osteoarthritis and low back pain. Participants will explore medication options, lifestyle modifications, and the roles of multidisciplinary team members in managing these conditions. Test your knowledge on effective pain management methods and the characteristics of back pain.

More Like This

Management of Osteoarthritis (OA)
17 questions

Management of Osteoarthritis (OA)

FruitfulComputerArt avatar
FruitfulComputerArt
Osteoarthritis Treatment and Management Quiz
42 questions

Osteoarthritis Treatment and Management Quiz

SteadfastActinium avatar
SteadfastActinium
Equine Joint Disease Quiz
44 questions

Equine Joint Disease Quiz

SimplerBouzouki avatar
SimplerBouzouki
Use Quizgecko on...
Browser
Open
Browser
Browser