Back Pain Back Pain Medications and Therapies 2

Question 1

Which topical medication is available over the counter and approved for localized back pain relief in the US?

Accepted Answer

Diclofenac gel (Voltaren)

Answer

Diclofenac gel (Voltaren Arthritis Pain) is an OTC topical NSAID that provides localized anti-inflammatory analgesia with minimal systemic absorption.

Question 2

Gabapentin and pregabalin reduce neuropathic back pain by blocking which ion channels?

Accepted Answer

Voltage-gated calcium channels (alpha-2-delta subunit)

Answer

Gabapentinoids bind to the alpha-2-delta subunit of voltage-gated calcium channels, reducing release of excitatory neurotransmitters from sensitized neurons.

Question 3

Which injection technique delivers medication directly into the epidural space via the sacral hiatus?

Accepted Answer

Caudal epidural

Answer

Caudal epidural injections use the sacral hiatus as an entry point into the epidural space, providing a safe approach to deliver corticosteroids in lumbar/sacral pain.

Question 4

What is the mechanism of action of lidocaine trigger point injections for myofascial back pain?

Accepted Answer

Disrupting the trigger point and blocking sodium channels to reduce pain signaling

Answer

Lidocaine injected into trigger points disrupts the taut band cycle, blocks Na+ channels in nociceptors, and reduces sensitization of the trigger point.

Question 5

Intrathecal drug delivery systems (pain pumps) for chronic back pain deliver medication to which location?

Accepted Answer

Into the intrathecal (subarachnoid) space surrounding the spinal cord

Answer

Intrathecal pumps deliver medication (opioids, baclofen, ziconotide) directly into the CSF surrounding the spinal cord, achieving analgesia at much lower doses.

Back Pain Practice Test

Back Pain Practice Test

Back Pain Back Pain Medications and Therapies 2