Back Pain Back Pain Treatment and Management 1 — Questions and Answers
Question 1: What is the recommended first-line treatment for acute non-specific low back pain according to US clinical guidelines?
- Opioid analgesics
- Bed rest for 7 days
- Staying active and non-pharmacological care (Correct answer)
- Immediate MRI and surgery referral
Correct answer: Staying active and non-pharmacological care
Current guidelines recommend staying active, reassurance, and non-pharmacological interventions (heat, exercise, manual therapy) as first-line for acute non-specific LBP.
Question 2: Which class of medication is recommended as first-line pharmacological treatment for acute back pain when needed?
- Opioids
- NSAIDs (Correct answer)
- Muscle relaxants
- Gabapentinoids
Correct answer: NSAIDs
NSAIDs (e.g., ibuprofen, naproxen) are recommended as the first-line pharmacological option for acute LBP due to their anti-inflammatory and analgesic effects.
Question 3: McKenzie Method (Mechanical Diagnosis and Therapy) for back pain is primarily based on which concept?
- Core strengthening exercises
- Directional preference and centralization of pain (Correct answer)
- Stretching the hamstrings and hip flexors
- Manual spinal manipulation
Correct answer: Directional preference and centralization of pain
The McKenzie Method identifies a directional preference (usually extension) that centralizes radicular pain, using repeated movements to reduce disc-related symptoms.
Question 4: At which stage of disc herniation recovery is spinal surgery (discectomy) typically indicated?
- Within the first 2 weeks of pain onset
- After 4-6 weeks of failed conservative care with progressive neurological deficit (Correct answer)
- Immediately when an MRI shows herniation
- After 1 year of pain
Correct answer: After 4-6 weeks of failed conservative care with progressive neurological deficit
Surgery for disc herniation is indicated when there is persistent radiculopathy after 4-6 weeks of conservative care, or immediately with progressive neurological deficits.
Question 5: Which type of injection is used to deliver corticosteroids near an irritated spinal nerve root?
- Trigger point injection
- Epidural steroid injection (Correct answer)
- Prolotherapy
- Facet joint injection
Correct answer: Epidural steroid injection
Epidural steroid injections deliver corticosteroids into the epidural space near compressed nerve roots to reduce inflammation and radicular pain.
Question 6: Cognitive Behavioral Therapy (CBT) for back pain primarily targets which aspect of the condition?
- Structural spinal abnormalities
- Pain catastrophizing and avoidance behaviors (Correct answer)
- Muscle strength deficits
- Inflammation reduction
Correct answer: Pain catastrophizing and avoidance behaviors
CBT addresses maladaptive thoughts (catastrophizing, fear-avoidance) and behaviors that perpetuate disability, improving function and quality of life.
Back Pain Back Pain Treatment and Management 1
What is the recommended first-line treatment for acute non-specific low back pain according to US clinical guidelines?