Term
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Definition
Most common in patients 20-40 years
70-80% experience this at one point in their lives
5th most common reason for office visits |
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Term
| Low back pain diagnostics |
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Definition
Xrays are not always necessary, unless trauma or other determining factors
MRI/CT scan |
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Term
| Nonpharmacological Back Pain Treatment & Mgmt |
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Definition
Most will improve in the first month
Discourage bed rest/encourage activity – let pain be guide
Heat/Cold
Exercises (self or PT)-knee/chest, wall
Education on proper back mechanics
Massage therapy
Acupuncture
Spinal manipulation
Weight loss |
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Term
| Pharmacological Back Pain Treatment & Mgmt |
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Definition
NSAIDs/Tylenol
Opioids (avoid if possible or only short-term)
Muscle relaxant
Anti-depressants (for chronic pain)
Gabapentin (Neurontin)
ESI Epidural steroid injections (for pts with radicular pain due to herniated disc
Short term steroids-Medrol dose pak |
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Term
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Definition
Most do not require this line of tx
Consider after 4-6 months of failure of non-invasive treatments for herniated disc
Cauda equina syndrome
Persistent neuromotor deficit
Radicular pain after 4-6 weeks
Most benefits seen with surgery occur during first 1-2 years-at the end of this time non-surgical patients are doing just as well
Discectomy |
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Term
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Definition
Many causes for neck pain
Musculoskeletal
Non-musculoskeletal
Neck pain is very common c/o in primary care
Often mistaken for shoulder c/o-must always rule out cervical spine when evaluating arm c/o |
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Term
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Definition
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Term
| Pharmacological Treatments or Neck Pain |
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Definition
Pain medication
Muscle relaxants
NSAIDs/COX 2
Anti-depressants |
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Term
| Non-pharmacological Neck Treatments |
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Definition
Ice
Exercises/PT
ESI
Surgery
Lifestyle changes |
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Term
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Definition
| If patient does not get better after 4 weeks of pharmacological and nonpharmacological treatment consider additional testing/referral |
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Term
Low back pain can be caused by all of the following EXCEPT:
a. cholecystitis
b. AAA
c. PID
d. spinal stenosis |
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Definition
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Term
Bill comes in for low back pain secondary to improper body mechanics while lifting. Appropriate interventions the first visit include all of the following EXCEPT:
a. treatment with Ibuprofen 600 q 6 hrs w/ food.
b. ice to affected area for 24-48 hours
c. back stretching exercises as pain permits
d. x-ray of lumbar spine |
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Definition
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Term
You receive a phone call after 2 weeks saying Bill's pain has decreased from 5/10 to a 3/10. He reports no radiculopathy or new sx's. He has been taking Ibuprofen nd doing stretching exercises when he remembers. Appropriate intervention at this time would be:
a. Ask Bill to come back in the office for assessment.
b. Obtain a MRI of the spine
c. Order Medrol Dose pak
d. Refer to an orthopedist. |
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Definition
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Term
A potentially fatal cause of neck pain may be:
a. viral meningitis
b. bacterial meningitis
c. cervical strain
d. spinal stenosis |
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Definition
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Term
Appropriate education of the client with an acute cervical strain includes:
a. proper sleep position
b. use of a cervical collar
c. instruction regarding LT use of narcotics
d. instruction regarding surgical interventions |
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Definition
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