Back Pain Back Pain Treatment and Management 2 — Questions and Answers
Question 1: What is the primary goal of lumbar stabilization exercises in back pain rehabilitation?
- Increasing spinal flexibility
- Training co-contraction of deep muscles to protect the spine during movement (Correct answer)
- Stretching the posterior chain
- Improving cardiovascular fitness
Correct answer: Training co-contraction of deep muscles to protect the spine during movement
Lumbar stabilization exercises train the deep core muscles (multifidus, transversus abdominis) to co-contract and provide dynamic stability to protect spinal segments.
Question 2: Which surgical procedure involves removing the lamina to decompress the spinal canal in stenosis?
- Discectomy
- Spinal fusion
- Laminectomy (Correct answer)
- Foraminotomy
Correct answer: Laminectomy
Laminectomy involves removing part or all of the lamina (back of the vertebral arch) to enlarge the spinal canal and relieve neural compression in stenosis.
Question 3: Which physical therapy approach uses high-velocity, low-amplitude thrusts to the spine?
- Massage therapy
- Traction
- Spinal manipulation (Correct answer)
- Dry needling
Correct answer: Spinal manipulation
Spinal manipulation (as performed by chiropractors and physical therapists) uses HVLA thrusts to restore joint mobility and reduce pain.
Question 4: Transcutaneous Electrical Nerve Stimulation (TENS) for back pain works primarily through which mechanism?
- Reducing spinal inflammation
- Gate control theory — inhibiting pain signal transmission (Correct answer)
- Strengthening paraspinal muscles
- Improving disc hydration
Correct answer: Gate control theory — inhibiting pain signal transmission
TENS activates large-diameter sensory fibers that inhibit pain transmission via the gate control mechanism in the dorsal horn of the spinal cord.
Question 5: Which activity modification is most important to teach patients with lumbar disc herniation?
- Avoid all bending and lifting indefinitely
- Avoid prolonged sitting and use proper lifting technique (spine neutral) (Correct answer)
- Bed rest with no activity for 4 weeks
- Use a corset brace at all times
Correct answer: Avoid prolonged sitting and use proper lifting technique (spine neutral)
Patients with disc herniation should minimize prolonged sitting, avoid spinal flexion under load, and maintain a neutral spine when lifting to reduce intradiscal pressure.
Question 6: Radiofrequency ablation (RFA) for back pain targets which structure?
- Intervertebral discs
- Medial branch nerves supplying the facet joints (Correct answer)
- Sciatic nerve
- Paraspinal muscles
Correct answer: Medial branch nerves supplying the facet joints
Lumbar RFA uses heat to ablate the medial branch nerves that carry pain signals from facet joints, providing long-term relief in facet-mediated back pain.
Back Pain Back Pain Treatment and Management 2
What is the primary goal of lumbar stabilization exercises in back pain rehabilitation?