Understanding Low Back Pain Causes and Treatments

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Questions and Answers

Which of the following is NOT a common cause of low back pain?

Pain radiating down the leg

Disk degeneration or herniation

Muscle/ligament strain

Exogenous infection (correct)

What symptom might indicate a more severe case of low back pain?

Leg weakness (correct)

Paresthesia in the arms

Episodic pain

Reduced flexibility

Which preventive measure should be taken to avoid exacerbating low back pain?

Bend at the waist when lifting

Keep knees bent when lifting (correct)

Change positions rarely

Lift objects away from the body

Which medication is commonly used for chronic back pain management?

Tricyclic antidepressants (B) Signup and view all the answers

What is a primary characteristic of osteoarthritis?

Wear and tear causing joint degradation (C) Signup and view all the answers

Which of the following is a main treatment for osteomyelitis?

Antibiotics for 6 weeks (B) Signup and view all the answers

What is a recommendation for managing osteoarthritis pain?

Taking pain medication before exercise (B) Signup and view all the answers

Which of the following is a method suggested for pain relief in chronic back pain?

Corticosteroid injections (C) Signup and view all the answers

Which lifestyle change is recommended to manage osteoporosis?

Regular weight-bearing exercise (C) Signup and view all the answers

What is the primary goal in managing gout?

Maintain uric acid level below 6mg/dL (A) Signup and view all the answers

Which of the following is NOT a common risk factor for osteoporosis?

Regular exercise (C) Signup and view all the answers

What is a typical finding in patients with osteomalacia?

Gait with a waddle (D) Signup and view all the answers

Which medication is used to decrease uric acid levels in chronic gout?

Allopurinol (B) Signup and view all the answers

What dietary changes should a patient with gout make?

Limit shellfish consumption (C) Signup and view all the answers

What is the main purpose of a DEXA scan in osteoporosis management?

To detect early bone loss (C) Signup and view all the answers

Which symptom would suggest carpal tunnel syndrome?

Paresthesia in the thumb and fingers (D) Signup and view all the answers

What is a priority assessment for a patient post-carpal tunnel surgery?

Conduct neurovascular checks (B) Signup and view all the answers

Which treatment is recommended for phantom limb pain?

Use gabapentin (D) Signup and view all the answers

Study Notes

Low Back Pain

Common causes include muscle or ligament strain and disk degeneration or herniation.
Symptoms may radiate down the leg, possibly causing paresthesia, leg weakness, and bowel or bladder issues.
Treatment options include OTC analgesics, opioids (short-term), muscle relaxants like cyclobenzaprine, tricyclic antidepressants, SSRIs, anticonvulsants, and corticosteroid injections.
Non-pharmacological approaches: ice/heat therapy, massage, chiropractic care, and yoga.
Prevention methods: regular stretching, frequent position changes, keeping knees bent when lifting, lifting objects close to the body, and avoiding twisting or reaching.

Osteoarthritis

Results from wear and tear on joints, leading to degradation of joint structures and decreased lubrication.
Symptoms include unilateral or bilateral joint pain, stiffness, and functional impairment.
Pain worsens with exercise and improves with rest.
Goals are to relieve pain, reduce stiffness, and maintain mobility.
Treatment includes NSAIDs (monitor for GI bleeding), acetaminophen (APAP), opioids, steroid injections, and possibly surgery (arthroplasty).
Patient education emphasizes daily walking, using assistive devices, and taking pain medication before exercise.

Osteomyelitis

Can originate from exogenous (direct exposure), endogenous (bacteria in bloodstream), or contiguous sources (from adjacent infection).
Symptoms include fever (usually >101°F), constant throbbing pain, and swelling at the affected area.
Treatment involves a 6-week course of antibiotics and possible debridement.
Risk factors include IV drug abuse, history of diabetes, infected wounds, and orthopedic surgery.

Osteomalacia

Caused by vitamin D deficiency, leading to bone softening and symptoms such as muscle weakness and waddling gait.
Treatment includes vitamin D supplementation.
Patient education focuses on increasing sunlight exposure and dietary intake of vitamin D-rich foods, like cheese, egg yolks, dairy, fish with bones, mushrooms, and fortified cereals.

Osteoporosis

Characterized by increased osteoclast activity, resulting in decreased bone density.
Risk factors include advanced age, menopause, smoking, thin body type, sedentary lifestyle, and corticosteroid use.
Typically asymptomatic but can lead to fractures and decreased height.
Treatment includes vitamin D and calcium supplementation, bisphosphonates (e.g., alendronate), and epinatri-acide clinic recommendations.
Patient education includes proper bisphosphonate administration, DEXA scan for early detection, and engaging in weight-bearing exercises.

Gout

Results from uric acid accumulation in joints, often due to purine metabolism errors.
Symptoms include swelling, warmth, redness, and pain in smaller joints, especially the great toe, and the presence of tophi.
Treatment aims to maintain uric acid levels below 6 mg/dL, with options for inflammation reduction (NSAIDs, colchicine) and chronic management (probenecid, allopurinol).
Patients should avoid high-purine foods (red meat, organ meats, shellfish), limit alcohol, and be cautious with thiazide diuretics.

Carpal Tunnel Syndrome

Caused by median nerve compression in the wrist, leading to paresthesia and pain in fingers.
Positive Phalen maneuver indicates issue presence.
Treatment options include NSAIDs, steroid injections, wrist braces, and surgery to relieve nerve pressure.
Postoperative care focuses on neurovascular checks and restricting hand movements for 4-6 weeks.

Amputations

Can be elective (often due to peripheral vascular disease) or traumatic in nature.
Phantom limb pain may occur, described as burning or twisting sensations.
Management involves medications like gabapentin and calcitonin, as well as using TENS units.
Complications to monitor include impaired tissue perfusion, infection, and flexion contractures, with recommended interventions like prone positioning and range of motion exercises.

Rheumatoid Arthritis

Autoimmune condition causing joint inflammation due to immune system attack.

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Description

This quiz explores the causes of low back pain, including muscle strains and disk issues, and the symptoms that may accompany it. Additionally, it covers various treatments, ranging from OTC medications to alternative therapies and preventive measures. Test your knowledge on effective strategies for managing and preventing low back pain.