Back Pain Back Pain Medications and Therapies

Question 1

Which NSAID is most commonly recommended for back pain due to its favorable GI safety profile when used with a proton pump inhibitor?

Accepted Answer

Celecoxib (COX-2 inhibitor)

Answer

Celecoxib selectively inhibits COX-2 with less GI mucosal damage than non-selective NSAIDs, making it preferable for patients at GI risk.

Question 2

Cyclobenzaprine, used as a muscle relaxant for back spasm, acts primarily on which structure?

Accepted Answer

Spinal cord interneurons and brainstem

Answer

Cyclobenzaprine acts centrally on the brainstem and spinal cord to reduce tonic somatic motor activity, relieving muscle spasm.

Question 3

Which opioid analgesic property is most relevant to its risk of causing physical dependence in back pain patients?

Accepted Answer

Mu-receptor binding and tolerance development

Answer

Opioid binding to mu-receptors leads to neuroadaptation and tolerance, resulting in physical dependence with regular use.

Question 4

Duloxetine (Cymbalta) is FDA-approved for chronic low back pain and works by which mechanism?

Accepted Answer

Inhibiting serotonin and norepinephrine reuptake (SNRI)

Answer

Duloxetine is an SNRI that enhances descending inhibitory pain pathways via norepinephrine and serotonin, reducing central sensitization in chronic pain.

Question 5

What is the primary risk of long-term systemic corticosteroid use for back pain management?

Accepted Answer

Osteoporosis, adrenal suppression, and hyperglycemia

Answer

Long-term systemic steroids cause significant side effects including osteoporosis (worsening spinal health), adrenal suppression, and metabolic effects like hyperglycemia.

Back Pain Practice Test

Back Pain Practice Test

Back Pain Back Pain Medications and Therapies