Back Pain Essentials Of Back Pain 5 — Questions and Answers
Question 1: Pain radiating from the buttock down the back of the leg to the foot, following a dermatomal pattern, is best described by which term?
- Radiculopathy (Correct answer)
- Myelopathy
- Claudication
- Fibromyalgia
Correct answer: Radiculopathy
Radiculopathy is dermatomal pain from nerve root compression or irritation, commonly called sciatica when involving the sciatic distribution.
Question 2: A patient's MRI shows a disc bulge, but they have no pain or neurologic symptoms. What is the best interpretation?
- Immediate surgery is required
- Disc bulges are common incidental findings in asymptomatic adults (Correct answer)
- The MRI must be repeated with contrast
- The patient is hiding symptoms
Correct answer: Disc bulges are common incidental findings in asymptomatic adults
Disc bulges appear in a large proportion of pain-free adults, so imaging findings must be correlated with symptoms.
Question 3: Which duration of symptoms defines chronic low back pain?
- More than 1 week
- More than 4 weeks
- More than 12 weeks (Correct answer)
- More than 12 months
Correct answer: More than 12 weeks
Low back pain persisting beyond 12 weeks is classified as chronic.
Question 4: A 30-year-old gymnast has low back pain worsened by spinal extension, and imaging reveals a defect in the pars interarticularis. What is this condition called?
- Spondylolysis (Correct answer)
- Scoliosis
- Kyphosis
- Discitis
Correct answer: Spondylolysis
Spondylolysis is a stress defect of the pars interarticularis, common in athletes who perform repetitive hyperextension.
Question 5: Which lifestyle factor is most consistently linked to an increased risk of developing low back pain?
- Moderate daily walking
- Cigarette smoking (Correct answer)
- Adequate vitamin D intake
- Swimming regularly
Correct answer: Cigarette smoking
Smoking impairs disc nutrition and is consistently associated with higher rates of low back pain.
Question 6: During examination, pain reproduced when the examiner raises the patient's unaffected leg (crossed straight leg raise) suggests what?
- Malingering
- A highly specific sign of disc herniation (Correct answer)
- Hip joint arthritis
- Hamstring tightness
Correct answer: A highly specific sign of disc herniation
A positive crossed straight leg raise is less sensitive but highly specific for lumbar disc herniation.
Question 7: Which patient education message is most accurate for someone recovering from an episode of nonspecific low back pain?
- The spine is fragile and should be protected from all bending
- Most episodes improve substantially within a few weeks with gradual return to activity (Correct answer)
- Pain always indicates ongoing tissue damage
- Recurrence means permanent disability is likely
Correct answer: Most episodes improve substantially within a few weeks with gradual return to activity
Most acute nonspecific back pain improves within weeks, and reassurance with gradual activity supports recovery.
Back Pain Essentials Of Back Pain 5
Pain radiating from the buttock down the back of the leg to the foot, following a dermatomal pattern, is best described by which term?