7.

The following drugs should be considered

LOW BACK PAIN MCQ of value in the management of acute low back
answers pain:

 Paracetamol 
1. Low back pain is generally understood to  NSAIDs 
become ‘chronic’ after a period of how long?  Muscle relaxants 
 Narcotic analgesics
 6 weeks
 12 weeks  8. Which of the following are ‘red flags’ for
 20 weeks possible serious spinal pathology?

2. What proportion of the population will  Age over 55 

develop low back pain at some time their  Anorexia
lives?  Systemic steroid therapy 
 Difficulty with micturition 
 20%  Cough-impulse pain
 50%
 70% 
 90%

3. At what age does low back pain occur most 9. What are the risk factors for chronicity?
commonly?
 Previous history of low back pain 
 20-30 years  Nerve root signs 
 35-55 years   Medico-legal compensation claim 
 50-65 years  Heavy smoking 
 Depressive symptoms 
4. What proportion of low back pain sufferers
go on to develop chronic low back pain? 10. For which of the following interventions is
there overall evidence of benefit?
 10%
 2-7%   Activity (avoidance of bed rest) 
 20%  NSAIDs 
 5-10%  Epidural injections
 Back exercises
5. How much radiation is involved in a plain  Traction
lumbar spine X-ray compared to a chest X- 
ray? 11. In the management of chronic back pain
which interventions are known to be
 Equal amounts beneficial for some patients?
 Lumbar spine = 2 x Chest X-Ray
 Lumbar spine = 20 x Chest X-Ray  Advice to stay active 
 Lumbar spine = 150 x Chest X-Ray   Epidural corticosteroid injections
 NSAIDs
6. What is the role of psychosocial factors in  Spinal manipulation 
chronic low back pain?  Microdiscectomy
 Psychosocial factors only come into 12. Which features suggest nerve root pain?
play when the low back pain is very
prolonged  Radiation to foot 
 Psychosocial factors influence  Reduced straight leg raising causing
response to treatment and back pain
rehabilitation   Weakness in both feet
 Biomedical factors are more  Numbness and paraesthesiae
important than psychosocial factors radiating to the foot or toes 
in determining chronicity