Flashcards in this deck (60)

• What is low back pain?

  Pain in the lumbosacral area of the back, between the bottom of the ribs and the top of the legs.
  health pain
• How is low back pain usually described?

  As non-specific, mechanical, musculoskeletal, or simple.
  health pain
• What percentage of people report persistent back pain after an acute episode?

  Up to 1/3 of people.
  health pain
• What are common risk factors for chronic low back pain?

  Identifying risk factors can predict when an episode becomes persistent.
  health pain
• What is the guidance for low back pain and sciatica?

  Assessment and management for people aged 16 and over, as per NICE.
  health guidelines
• What is the most common type of lower back pain?

  Nonspecific lower back pain, often sudden-onset (acute).
  health pain
• What are potential causes of nonspecific lower back pain?

  • Over-stretching of ligaments or muscles
  • Minor disc issues
  • Minor facet joint problems
  health pain
• What are symptoms of lower back pain?

  • Pain after lifting heavy
  • Pain after twisting
  • Pain spreading to buttocks/thighs
  • Eased by lying down
  • Pain with movement, coughing, sneezing
  health symptoms
• What is the prevalence of low back pain?

  Up to 60% of the population will experience it at some point.
  health statistics
• What is the rate of GP consultations for low back pain?

  Around 20% of people with low back pain consult their GP each year.
  health statistics
• How are musculoskeletal problems addressed in GP appointments?

  In one in 12 GP appointments.
  health statistics
• Who experiences back pain at a relatively young age?

  People in the most deprived areas.
  health demographics
• How likely are working-age people to report back pain?

  Twice as likely (17.7%) compared to those from least deprived areas.
  health demographics
• What are common conditions of musculoskeletal pain?

  • Osteoarthritis
  • Back pain
  health musculoskeletal
• When does musculoskeletal pain typically onset?

  Gradual onset, more common with rising age
  health musculoskeletal
• How many people in the UK have sought treatment for osteoarthritis?

  8.75 million people
  health statistics
• What areas does musculoskeletal pain affect?

  • Joints
  • Spine
  • Pain system
  health anatomy
• What is the primary treatment for musculoskeletal pain?

  • Physical activity
  • Pain management
  • Joint replacements (severe cases)
  health treatment
• What factors influence musculoskeletal pain?

  • Age
  • Sex
  • Genetic factors
  • Physical injury
  • Obesity
  • Previous joint illness
  health risk_factors
• What should be assessed in a patient with back pain?

  • Onset
  • Type
  • Site
  • Pattern of pain
  • Aggravating/relieving factors
  health assessment
• What is the economic impact of back pain in the UK?

  Estimated £1.6 billion direct and £10 billion indirect costs in 2000
  economy health
• What percentage of sickness absence in the NHS is due to back pain?

  Around 40%
  economy health
• What is the relationship between obesity and musculoskeletal problems?

  Obese individuals are four times more likely to develop back pain
  health obesity
• What is multimorbidity?

  Having 2 or more long-term health conditions at the same time
  health multimorbidity
• How does depression affect back pain risk?

  Odds of back pain are 50% higher in those with depression symptoms
  health mental_health
• What is the prevalence of low back pain in daily smokers?

  Approximately 50% higher compared to non-smokers
  health smoking
• What is a recommended pharmacological treatment for low back pain?

  Consider oral NSAIDs for managing low back pain
  health treatment
• What should be considered when prescribing oral NSAIDs?

  • Gastrointestinal toxicity
  • Liver toxicity
  • Cardio-renal toxicity
  health medication
• What is the recommended dose for oral NSAIDs?

  Lowest effective dose for the shortest possible period of time.
  medication nsaids
• When should weak opioids be considered?

  If NSAIDs are contraindicated, not tolerated, or ineffective for acute low back pain.
  pain_management opioids
• What is the prognosis for non-specific back pain?

  Mostly resolves within 4 weeks with self-care.
  prognosis back_pain
• What factors increase risk for long-term pain in low back pain?

  • Pain lasting longer than 12 weeks
  • Psychosocial distress
  • Maladaptive coping strategies
  • Catastrophizing
  risk_factors back_pain
• What is sciatica?

  Pain in the distribution of the sciatic nerve, often felt in the thigh and below the knee.
  sciatica pain
• What causes sciatica?

  Neuropathic leg pain caused by compression of the lumbosacral nerve roots.
  sciatica neuropathy
• What is the treatment approach for sciatica?

  • Self-management
  • Exercise and physiotherapy
  • Manual therapies
  • Psychological programmes
  treatment sciatica
• What is the role of X-ray in non-traumatic low back pain?

  Limited role in most cases, only if red flags are present.
  investigations back_pain
• What is a risk stratification tool for low back pain?

  STarT Back risk assessment tool.
  risk_assessment back_pain
• What should be assessed if no red flag symptoms are present?

  Use a risk stratification tool like STarT Back pain.
  assessment back_pain
• What is the goal of shared decision making in low back pain management?

  Tailor advice and information to help self-manage low back pain.
  shared_decision management
• What is the goal of self-management for low back pain?

  Provide tailored advice and information to help individuals manage their condition throughout treatment.
  health self_management
• What type of support is recommended for those likely to improve quickly?

  Simpler and less intensive support.
  health support
• What type of support is recommended for those at higher risk of poor outcomes?

  More complex and intensive support.
  health support
• What is a non-pharmacological management option for low back pain?

  Referral for a group exercise programme.
  health management
• What psychological approach is suggested for low back pain management?

  Cognitive Behavioral Therapy (CBT).
  health psychology
• What are two tips to help ease back pain?

  • Strengthen core muscles
  • Stretch daily
  health tips
• What should NOT be offered for low back pain?

  • Acupuncture
  • Spinal injections
  health contraindications
• What medications should NOT be offered for managing sciatica?

  • Gabapentinoids
  • Opioids
  health medications
• What are some red flag symptoms to exclude in low back pain?

  • Cauda equina syndrome
  • Spinal fracture
  health red_flags
• What are signs of cauda equina syndrome?

  • Bilateral leg pain
  • Urinary retention
  health cauda_equina
• What is a red flag symptom for a spinal fracture?

  Sudden severe central spinal pain, relieved by lying down.
  health spinal_fracture
• What should be discussed regarding the use of opioids for sciatica?

  Explain the risks of continuing these medicines.
  health medications
• What is the expected duration of pain for low back pain?

  Likely to have pain for 6 weeks (6/52).
  health expectations
• What is an important part of patient education in low back pain management?

  Discuss discharge instructions, both verbal and leaflet.
  health education
• What can cause spinal fractures in individuals?

  • Osteoporosis
  • Corticosteroid use
  • Minor trauma
  • Heavy lifting
  health spine trauma
• What are signs of structural deformity in the spine?

  Visible changes in the spine's structure
  health spine deformity
• What indicates point tenderness over a vertebral body?

  Tenderness felt over a specific vertebra
  health spine symptoms
• What are red flags for potential cancer?

  • Age > 50
  • Gradual worsening pain
  • Severe lumbar pain
  • Night pain disrupting sleep
  • Localised spinal tenderness
  • No improvement after 4–6 weeks
  • Unexplained weight loss
  • Claudication
  health cancer symptoms
• What types of cancer are likely to metastasize to the spine?

  • Breast cancer
  • Lung cancer
  • Prostate cancer
  • Renal cancer
  • Gastric cancer
  health cancer metastasis
• What conditions are associated with spinal infections?

  • Discitis
  • Vertebral osteomyelitis
  • Spinal epidural abscess
  health infection spine
• What are red flags for spinal infections?

  • Fever
  • Recent UTI
  • History of TB
  • Diabetes
  • History of IV drug use
  • HIV infection
  • Immunocompromised status
  health infection symptoms