Back Pain Question and Answers

Question 1

A 15-year-old female elite gymnast with low back discomfort who began experiencing symptoms slowly over the past few weeks arrives at your clinic. She disputes any recent wounds.

You observe that she has a hyperlordotic posture during a physical examination. Her hamstrings are so tight that she can't touch her toes. Her single-leg extension test was successful. Spondylolysis is the diagnosis you offer her.

Which of the ensuing assertions concerning spondylolysis is true?

Accepted Answer

The condition is connected to degenerative pars interarticularis alterations.

Answer

The disorder usually requires surgical intervention

Answer

The disorder most commonly occurs at the L1-L2 vertebral interface.

Answer

The disorder may present at birth.

Question 2

A 55-year-old woman arrives at your office and claims that she has been experiencing low back discomfort for three days as a result of falling on the ice.

During her physical examination, the lumbar paravertebral muscles on both sides of her show soft tissue soreness and spasm. Her deep tendon reflexes and lower extremity exams are both within normal ranges.

Which of the following treatments for her injuries would be an acceptable first-line pharmacologic management?

Accepted Answer

NSAIDs or skeletal muscle relaxants.

Answer

Tramadol or duloxetine.

Answer

Opioid analgesics for 3 days, then nonsteroidal anti-inflammatory drugs (NSAIDs), as needed.

Answer

Prednisone 20 mg/d for 14 days.

Question 3

When passively extending the quadriceps while the client is lying on the ground, severe low back pain indicates an issue with the:

Accepted Answer

L3 nerve root compression

Answer

Tight quadriceps muscles

Answer

Right C5-C6 nerve root compression was the source of the injury.

Answer

Low back muscles

Question 4

After falling from a ladder at work the day before, a 50-year-old house painter shows up to your office. He claims that as the top of a 10-foot ladder started to slide towards the wall, he jumped off and came to rest on his feet. Despite taking ibuprofen and using a heating pad, he experienced rapid onset mid-back pain that is still present today. He claims that no pain is traveling to his legs.

Upon physical examination, you discover point soreness at the level of T10 with intact neurologic function both at and below that level. A compression fracture of the T10 vertebral body is seen on the plain films that you ordered.

Regarding the treatment of this injury, which of the following assertions is true?

Accepted Answer

An x-ray showing rotation would show that the fracture is unstable.

Answer

Therapeutic management includes use of calcitonin

Answer

The diagnostic process includes checking for primary cancers that have spread to the bone.

Answer

You need to rule out osteoporosis.

Question 5

A 25-year-old man who has been employed to work at a nearby lumber supply company comes to your clinic for a physical. He is anxious despite being thrilled about his new employment choice because some of his buddies have suffered back ailments while working at the business. What can he do to prevent harm to his back, he enquires.

Which of the following suggestions may you provide him based on the US Preventive Services Task Force's (USPSTF) recommendations?

Accepted Answer

Although not always helpful in preventing back problems, healthy lifestyle choices like regular exercise and quitting smoking can have a positive impact on one's general health.

Answer

It has been demonstrated that educational initiatives at work have considerable, long-term advantages for back health.

Answer

Lumbar supports are useful in preventing back injuries

Answer

Back schools are useful for primary prevention of back injuries.

Question 6

What is the most likely source of pain on the left side of the genitalia when side-flexing to the right?

Accepted Answer

An iliolumbar ligament sprain

Answer

An adductor strain

Answer

Sacrotuberous ligament sprain

Answer

A urilogical problem

Question 7

Which nerve root or roots are responsible if the psoas is weak when tested?

Accepted Answer

L2 and L3

Answer

L4

Answer

L5

Answer

L4 and L5