1.3. Non-specific low back pain
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Questions and Answers

What does non-specific low back pain (NS-LBP) refer to?

  • Back pain that is not attributable to underlying serious spinal pathologies (correct)
  • Back pain attributed to underlying serious spinal pathologies
  • Back pain with specific lumbopelvic conditions
  • Back pain originating from the nervous system's altered perception
  • What is the term used to describe persistent pain originating from the nervous system's altered perception?

  • Discogenic pain
  • Structural impairment
  • Central sensitisation (correct)
  • Radiculopathy
  • Which condition is not considered a red flag for non-specific low back pain (NS-LBP)?

  • Radiculopathy (correct)
  • Vertebral fractures
  • Spondylolisthesis
  • Facet arthritis
  • What does 'central sensitisation' refer to in clients with nociplastic pain?

    <p>Altered nervous system function with altered perception of pain (B)</p> Signup and view all the answers

    Which of the following is not a condition that can affect the lumbar spine?

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

    What is the primary role of our lumbar spine?

    <p>Support the weight of our body (B)</p> Signup and view all the answers

    What age range is considered older for men in the context of alerting features for back pain?

    <p>65 years (B)</p> Signup and view all the answers

    Which imaging technique is recommended for immediate assessment in patients with spinal infection?

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

    What is a common risk factor that warrants immediate assessment for spinal malignancy?

    <p>Unexplained weight loss (D)</p> Signup and view all the answers

    Which condition presents as progressive lower limb motor weakness and severe neurologic deficits?

    <p>Cauda equina syndrome (C)</p> Signup and view all the answers

    What is the key feature of axial spondyloarthritis that should prompt a referral to a rheumatologist?

    <p>Positive family history of spondyloarthritis (D)</p> Signup and view all the answers

    In the context of LBP, what is the term used to describe an increased responsiveness of nociceptive neurons to their normal input?

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

    'Nociplastic pain' originates from altered nociception with sensitisation in which part of the nervous system?

    <p>'Central sensitisation' (A)</p> Signup and view all the answers

    Which type of pain is defined by increased responsiveness of nociceptive neurons in the absence of evidence for tissue damage/injury?

    <p>'Nociplastic pain' (C)</p> Signup and view all the answers

    'Peripheral sensitisation' in chronic pain conditions involves altered nociception processing at which level of the nervous system?

    <p>Peripheral nervous system (D)</p> Signup and view all the answers

    'Central sensitisation' leads to increased responsiveness of nociceptive neurons in the absence of straightforward evidence for what?

    <p>'Tissue damage/injury' (C)</p> Signup and view all the answers

    What is responsible for pain modulation and inhibition in the neural pathways?

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

    What is the first step in assessing central sensitisation symptoms?

    <p>Ruling out neuropathic pain (D)</p> Signup and view all the answers

    Which criteria are used to confirm neuropathic pain according to the IASP-NeuPSIG guidelines?

    <p>Evidence of positive physical and neurological examination (C)</p> Signup and view all the answers

    What tool is often used to assess allodynia?

    <p>Light touch with a cotton swab (D)</p> Signup and view all the answers

    Which aspect mediates sensitization processes related to central sensitisation symptoms?

    <p>Fear-avoidance behaviors (C)</p> Signup and view all the answers

    According to Nijs et al., (2014), what is Criterion 1 to confirm the presence of central sensitisation symptoms?

    <p>Pain experience disproportionate to injury or pathology (C)</p> Signup and view all the answers

    What percentage of clients with chronic NSLBP present with widespread pain according to the text?

    <p>25-38% (D)</p> Signup and view all the answers

    Which area is NOT mentioned as being associated with widespread pain in clients with chronic musculoskeletal pain?

    <p>&quot;On the head&quot; (D)</p> Signup and view all the answers

    What term is often used interchangeably with 'NS-LBP' in musculoskeletal practice?

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

    How is Mechanical Low Back Pain typically described in terms of symptoms?

    <p>Pain features specific to nerve and bony dysfunction (A)</p> Signup and view all the answers

    What can make it difficult to differentiate muscle, joint, and disc dysfunction related mechanical pain?

    <p>At times, it is difficult to differentiate (B)</p> Signup and view all the answers

    What age group is NS-LBP most common in?

    <p>35-55 years (A)</p> Signup and view all the answers

    What is the key characteristic of 'Primary Chronic Pain' according to the text?

    <p>Characterised by significant emotional distress or functional disability (C)</p> Signup and view all the answers

    What do the conditions under 'Primary Chronic Pain' have in common?

    <p>They include musculoskeletal, headache, and visceral pain (D)</p> Signup and view all the answers

    'Primary Chronic Pain' is conceived as a what by the text?

    <p>'Disease' rather than a symptom (A)</p> Signup and view all the answers

    'Complex regional pain syndromes' will be discussed in which unit according to the text?

    <p>'Topic-3' (B)</p> Signup and view all the answers

    'Fibromyalgia' falls under which category of 'Primary Chronic Pain' conditions?

    <p>'Chronic Primary Musculoskeletal Pain' (B)</p> Signup and view all the answers

    'Repetitive stress: Heavy physical activity and prolonged static postures' are common physical risk factors of what condition according to the text?

    <p>'Nociplastic-LBP' (D)</p> Signup and view all the answers

    What is considered an important 'yellow flag' for the development of chronic or persistent NS-LBP?

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

    Which tool is used as a back pain screening tool to identify clients at risk of developing chronic LBP?

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

    What lifestyle factor is NOT mentioned as a modifiable risk factor for NS-LBP?

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

    Which clinical features should be considered before diagnosing NS-LBP?

    <p>Understanding cognitive and behavioral risk factors (C)</p> Signup and view all the answers

    Which age group is mentioned as a biological comorbidity risk factor for NS-LBP?

    <p>&gt;20 years (B)</p> Signup and view all the answers

    What should be done before deciding on NS-LBP as a potential diagnostic classification?

    <p>Identify common signs and symptoms (A)</p> Signup and view all the answers

    'StarTBack' is often used as a back pain screening tool to identify clients at risk of developing which type of back pain?

    <p>'StarTBack' identifies chronic LBP (D)</p> Signup and view all the answers

    'Central sensitisation' is an indicator of abnormal pain perception due to:

    <p>'Central Sensitisation Inventory (CSI)' (A)</p> Signup and view all the answers

    What social factor is mentioned as a risk factor for chronic or persistent NS-LBP?

    <p>Socioeconomic status (C)</p> Signup and view all the answers

    Which assessment tool is commonly used to identify and measure fear-avoidance behaviors in clients with chronic musculoskeletal pain symptoms?

    <p>Fear-Avoidance Components Scale (A)</p> Signup and view all the answers

    What is classified as 'Acute and subacute low back pain with related cognitive and affective tendencies' in the ICF impairment-based classification?

    <p>High scores on the Pain Catastrophizing Scale (B)</p> Signup and view all the answers

    Which management approach is recommended as the primary/first-line treatment for individuals with non-specific low back pain (NS-LBP)?

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

    Which of the following is NOT a second-line treatment option for non-specific low back pain (NS-LBP)?

    <p>Cognitive Functional Therapy (B)</p> Signup and view all the answers

    According to the NSW Agency for Clinical Innovation, what is NOT recommended for individuals with non-specific low back pain (NS-LBP)?

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

    Which tool is consistent with excessive anxiety or fear when high scores are observed?

    <p>Fear-Avoidance Components Scale (C)</p> Signup and view all the answers

    What does high scores on the Pain Catastrophizing Scale indicate?

    <p>Cognitive dysfunctions such as high helplessness (D)</p> Signup and view all the answers

    According to the Fear-avoidance model, what behavior do individuals with chronic musculoskeletal pain exhibit?

    <p>Avoidance of physical and/or occupation activities (D)</p> Signup and view all the answers

    What is the significance of assessing central sensitisation in clients with chronic non-specific low back pain?

    <p>It plays an integral role in the timely management of low back pain (C)</p> Signup and view all the answers

    What score on the Central Sensitization Inventory indicates the presence of central sensitisation?

    <p>At least 40 (C)</p> Signup and view all the answers

    Which factor is NOT associated with the Fear-avoidance model proposed by Vlaeyen and Linton?

    <p>Social engagement to reduce pain (C)</p> Signup and view all the answers

    What is one factor that may aggravate pain catastrophizing according to the text?

    <p>Inappropriate communication of diagnosis (B)</p> Signup and view all the answers

    How do individuals who catastrophize about their pain manage their fear according to the Fear-avoidance model?

    <p>By avoiding physical and occupation activities (D)</p> Signup and view all the answers

    What is one common consequence of chronic musculoskeletal pain according to the text?

    <p>Altered mood and emotions (D)</p> Signup and view all the answers

    Which statement accurately reflects the concept of pain catastrophizing?

    <p>It involves hypervigilance or magnification of pain symptoms. (A)</p> Signup and view all the answers

    'Less or poor support of family, friends, and social environment' is cited as a factor that may aggravate what aspect related to chronic pain?

    <p>'Reduced self-efficacy' (A)</p> Signup and view all the answers

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