Back Pain Back Pain Treatment and Therapy 2 — Questions and Answers
Question 1: Spinal cord stimulation (SCS) is typically considered for which back pain patient population?
- First-episode acute back pain
- Failed back surgery syndrome with chronic neuropathic pain (Correct answer)
- Patients with active infection
- Adolescents with scoliosis
Correct answer: Failed back surgery syndrome with chronic neuropathic pain
SCS is used for failed back surgery syndrome (FBSS) when conservative and surgical treatments have not provided adequate relief.
Question 2: Which class of medication is recommended for neuropathic component of back pain (e.g., radiculopathy)?
- NSAIDs
- Opioids as first line
- Gabapentinoids (gabapentin/pregabalin) (Correct answer)
- Corticosteroids
Correct answer: Gabapentinoids (gabapentin/pregabalin)
Gabapentinoids reduce neuropathic pain by blocking voltage-gated calcium channels in sensitized neurons.
Question 3: Laminectomy for lumbar spinal stenosis aims to achieve which outcome?
- Fuse adjacent vertebrae
- Remove the lamina to decompress the spinal canal (Correct answer)
- Replace a degenerated disc
- Stabilize a fracture
Correct answer: Remove the lamina to decompress the spinal canal
Laminectomy removes part or all of the lamina to enlarge the spinal canal and relieve compression of neural structures.
Question 4: Radiofrequency ablation (RFA) for back pain targets which structure to interrupt pain signals?
- Intervertebral disc
- Medial branch nerves supplying facet joints (Correct answer)
- Dorsal root ganglion of L4
- Anterior longitudinal ligament
Correct answer: Medial branch nerves supplying facet joints
RFA uses heat to ablate the medial branch nerves that innervate the facet joints, providing sustained pain relief.
Question 5: Which physical therapy modality uses electrical stimulation to reduce back pain and muscle spasm?
- Ultrasound therapy
- TENS (Transcutaneous Electrical Nerve Stimulation) (Correct answer)
- Hot packs only
- Dry needling
Correct answer: TENS (Transcutaneous Electrical Nerve Stimulation)
TENS delivers low-voltage electrical currents through skin electrodes to modulate pain signals via gate control mechanisms.
Question 6: Which intervention is most appropriate for a vertebral compression fracture causing acute back pain in an osteoporotic patient?
- Discectomy
- Spinal fusion
- Vertebroplasty or kyphoplasty (Correct answer)
- Laminectomy
Correct answer: Vertebroplasty or kyphoplasty
Vertebroplasty (cement injection) or kyphoplasty (balloon cavity creation + cement) stabilizes osteoporotic compression fractures.
Back Pain Back Pain Treatment and Therapy 2
Spinal cord stimulation (SCS) is typically considered for which back pain patient population?