Back Pain Back Pain 5 — Questions and Answers
Question 1: During pregnancy, back pain most commonly results from which combination of changes?
- Decreased body weight and tight ligaments
- Reduced lumbar curvature
- Lower levels of relaxin
- Shifted center of gravity and ligament-loosening hormones (Correct answer)
Correct answer: Shifted center of gravity and ligament-loosening hormones
The growing uterus shifts posture forward while relaxin loosens pelvic and spinal ligaments, straining the lower back.
Question 2: Cauda equina syndrome is characterized by which classic triad of findings?
- Saddle anesthesia, bladder dysfunction, and bilateral leg weakness (Correct answer)
- Headache, fever, and neck stiffness
- Unilateral foot drop, wrist pain, and rash
- Morning stiffness, fatigue, and dry eyes
Correct answer: Saddle anesthesia, bladder dysfunction, and bilateral leg weakness
Compression of the cauda equina produces saddle-area numbness, urinary retention or incontinence, and bilateral lower-limb deficits requiring emergency surgery.
Question 3: Which sleeping position is generally recommended to reduce low back strain?
- Face down with the head twisted
- On the back on a sagging soft mattress
- Curled tightly in a full fetal position on the stomach
- On the side with a pillow between the knees (Correct answer)
Correct answer: On the side with a pillow between the knees
Side-lying with a pillow between the knees keeps the spine and pelvis in neutral alignment.
Question 4: In evaluating chronic low back pain, facet joint pain is typically aggravated by which movement?
- Forward flexion only
- Deep breathing
- Ankle dorsiflexion
- Extension and rotation of the spine (Correct answer)
Correct answer: Extension and rotation of the spine
Leaning back and twisting loads the facet joints, reproducing facet-mediated pain.
Question 5: Which nonpharmacologic therapy has the strongest evidence for chronic low back pain?
- Prolonged bed rest
- Lumbar traction alone
- Wearing a back brace all day
- Structured exercise therapy (Correct answer)
Correct answer: Structured exercise therapy
Exercise therapy consistently shows benefit for pain and function in chronic low back pain, unlike rest, traction, or continuous bracing.
Question 6: A worker develops back pain with numbness in the big toe and weakness lifting the foot upward. Which nerve root is most likely involved?
- S2
- L1
- C7
- L5 (Correct answer)
Correct answer: L5
The L5 root supplies dorsiflexion of the foot and sensation to the dorsum of the foot and great toe.
Question 7: Which lifestyle factor is most strongly linked to slower healing and higher rates of chronic back pain?
- Drinking water regularly
- Cigarette smoking (Correct answer)
- Eating leafy greens
- Walking 30 minutes daily
Correct answer: Cigarette smoking
Smoking impairs disc nutrition and blood flow, increasing degeneration and delaying tissue healing.
Back Pain Back Pain 5
During pregnancy, back pain most commonly results from which combination of changes?