Back Pain Essentials Of Back Pain 4

Question 1

A patient with back pain has a fever of 101.5°F, recent IV drug use, and focal spinal tenderness. Which diagnosis must be ruled out first?

Accepted Answer

Vertebral osteomyelitis or epidural abscess

Answer

Fever with focal spinal tenderness in an IV drug user is a classic red flag triad for spinal infection.

Question 2

Which activity recommendation is most appropriate for a patient during the first days of acute nonspecific low back pain?

Accepted Answer

Staying active and continuing normal activities as tolerated

Answer

Evidence shows that staying active leads to faster recovery than bed rest for acute nonspecific back pain.

Question 3

Loss of the Achilles (ankle) reflex during examination most suggests compression of which nerve root?

Accepted Answer

S1

Answer

The Achilles reflex is mediated primarily by the S1 nerve root, commonly affected by L5-S1 disc herniation.

Question 4

A 68-year-old woman with osteoporosis develops sudden mid-back pain after a minor cough. What is the most likely cause?

Accepted Answer

Vertebral compression fracture

Answer

In osteoporotic patients, even trivial forces like coughing can cause vertebral compression fractures.

Question 5

Which nonpharmacologic therapy has the strongest evidence for managing chronic low back pain?

Accepted Answer

Exercise therapy

Answer

Structured exercise therapy is consistently supported by evidence as a core treatment for chronic low back pain.

Back Pain Practice Test