Low back pain – QUESTIONS well elaborated 2023/2024.

What is lower back pain most often due to? - answersmusculoskeletal problem What is localized lower back pain? - answerspatients will feel soreness when a specific area of lower back is palpated/pressed What is diffuse LBP? - answersoccurs over a larger area and comes from deep tissue What is radicular pain? - answerscaused by irritation of a nerve root. Not typically isolated to single location. radiates along nerve root ex: sciatica what is referred LBP? - answersFelt in the lower back but source of pain is in another location ex: kidney stones Why is lower back pain a common problem? - answers- bears most body weight - most flexible part of spine - contains nerve foots that are at risk for injury - naturally poor biomechanical structure What determines ACUTE back pain? - answers- lasts 4 weeks or less - caused by trauma or stress (hyper flexion, heavy lifting, sports injury) - symptoms usually appear in 24 hours, not at the time of injury, d/t pressure build up Why won't MRI/CT work to diagnose LBP? - answers- MRI findings are limited when increased edema is around injury - they will only work with trauma; won't pick up soft tissue soreness What is a disc herniation? - answersthe spongey part between discs ruptures/opens Why should we advise against sleeping in a prone position for patients who have LBP? - answersit produces excessive lumbar lordosis, placing excessive stress on the lower back Encourage patient to sleep in a supine or side-lying position with the knees and hips flexed to prevent unnecessary pressure on support muscles, ligaments, and lumbosacral joints. If patient MUST sleep on back - Sleep on back with a lift under knees and legs or back with 10-inch-high pillow under knees to flex hips and knees What type of mattress is recommended for LBP? - answersa firm mattress Why is smoking cessation important for patients who have LBP? - answersTobacco use impairs circulation to the intervertebral discs and may contribute to low back pain. Do you want to advise patients with LBP to prevent increased pain by placing a foot on a step or stool during prolonged standing? - answersyes Exercise __ minutes in the morning and evening regularly - answers15 What determines CHRONIC low back pain? - answers- longer than 3 months, involves repeated incapacitating episodes - often progressive, cause can be hard to determine What are some causes of chronic LBP? - answers- degenerative conditions like arthritis - osteoporosis - metabolic bone diseases - weakness from scar tissue of prior injury - chronic strain on lower back from obesity, pregnancy, stressful job postures - congenital spine problems What is spinal stenosis? - answersnarrowing of the spinal canal, commonly caused by osteoarthritis Manifestations of spinal stenosis? - answers- lower back pain that radiates to butt and leg - increased pain with walking, prolonged standing - numbness, tingling, weakness, heaviness in legs and butt - pain lessens when bending forward or sitting down What is a typical sign of spinal stenosis? - answersDecreased pain when the patient bends forward or sits down Pharmacologic measures for LBP - answers- Manage the patient's pain and stiffness with mild analgesics, such as NSAIDs, is integral to the daily comfort of the individual with chronic low back pain. - Antidepressants (e.g., duloxetine [Cymbalta]) may help with pain management and sleep problems. - The antiseizure drug gabapentin (Neurontin) may improve walking and relieve leg symptoms. Treatment for LBP - answers- Weight reduction - Sufficient rest periods - Local heat and cold application - Physical therapy - Exercise and activity throughout day - Complementary and alternative therapies