Low Back Pain 2024

pain is worsened by sitting and radiates down the back of leg which suggests - ANSWER sciatic pain and possibly herniated disk especially after unusual exertion classic presentation of herniated disk is? - ANSWER moderate to severe pain radiating from the back down the buttock and leg, usually to the foot or ankle, with associated numbness or paresthesias. This type of pain is called sciatica, and it is classically precipitated by a sudden increase in pressure on the disk, such as after coughing or lifting Disk disease is frequently? - ANSWER asymptomatic Herniated disk patients can have Numbness, paresthesias, and motor weakness found variably and can occur in the absence of what symptom? - ANSWER any of these can occur in the absence of pain. Most common site of weakness in herniated disk patient? - ANSWER is foot plantar or dorsiflexion in hernited disk patient Risk factors for herniated disk include - ANSWER sedentary activities, especially driving, chronic cough, lack of physical exercise, and possibly pregnancy. Jobs involving lifting and pulling have not been associated with increased risk 98% of clinical disk herniations are caused by which vertebrae regions? - ANSWER L4-L5 and L5-S1 cause, so pain and paresthesias are most often seen in these distributions. What aggravates herniated disc patients pain?Coughing, sneezing, or prolonged sitting can aggravate the pain. What aggravates herniated disc patients pain?///Coughing, - ANSWER Coughing, sneezing, or prolonged sitting can aggravate the pain.There are no bowel or bladder symptoms with unilateral disk herniations cauda equina syndrome definition and symptoms include? - ANSWER Cauda equina syndrome is a rare condition caused by tumor or massive midline disk herniations. It is characterized by the following:Urinary retention, Urinary incontinence, Decreased anal sphincter tone, Sensory loss in a saddle distribution, Bilateral sciatica, Leg weakness Straight leg test is performed by? - ANSWER holding the heel in 1 hand and slowly raising the leg, keeping the knee extended A positive test Straight leg test reproduces the patient's sciatica when the leg is elevated between - ANSWER 30 and 60 degrees Herniated disc patients who have positive straight leg test, should feel what during the test? - ANSWER The patient should describe the pain induced by the maneuver as shooting down the leg, not just a pulling sensation in the hamstring muscle Crossed straight leg test is performed by lifting the contralateral leg - ANSWER a positive test reproduces the sciatica in the affected leg A straight leg raise test that elicits back pain is negative for? - ANSWER sciatica Sciatica refers to what?///pain, weakness, numbness, or tingling in the leg. It is caused by injury to or pressure on the sciatic nerve Combinations of abnormal findings for herniated disc are? - ANSWER ( positive straight leg raise and neurologic abnormalities such as absent ankle reflex, impaired plantar or dorsiflexion, impaired sensation in L5-S1 distribution) Imaging test for viewing disk herniation that are used are? - ANSWER CT and MRI scans have similar test characteristics for diagnosing herniated disks. Electromyography (Might be useful in assessing possible nerve root dysfunction in patients with leg symptoms lasting more than 4 weeks not useful for isolated back pain) Plain radiographs do not image herniations - ANSWER ... Treatment for herniated disk in the absence of cauda equina syndrome or progressive neurologic dysfunction include the following? conservative therapy should be tried for 1 month. NSAIDs are the first choice, Opioids are often necessary, Bed rest does not accelerate recovery, Epidural corticosteroid injections may provide temporary pain relief. - ANSWER ... Surgery is indicated for herniated disk if the following are present? - ANSWER Impairment of bowel and bladder function (cauda equina syndrome),Gross motor weakness, Progressive neurologic symptoms or signs Back Pain Due to Metastatic Cancer classic presentation is? - ANSWER the development of constant, dull back pain that is not relieved by rest and is worse at night in a patient with a known malignancy