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afya DDbackPain

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20160425222528 Ben  
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//''Red flags''//
Age <20 or >50
Hx of malignancy
night pain
Hx of trauma
systemically unwell - fever, wt loss

''Facet joint''
acute or chronic
worse in morning and when standing
?pain over facets esp on extension (leaning backwards)

''Spinal stenosis''
gradual onset
uni or bilat leg pain (+/- back pain) numbness and weakness
worse on walking, resolves when sitting, leaning forwards or crouching down
described as aching or crawling
clinical exam often normal - needs MRI to confirm

''Ankylosing Spondylitis''
young man with pain and stiffness
usually worse in morning and resolves with activity
peripheral arteritis (25%, more common if F)

''Peripheral arterial disease''
pain on walking relieved by rest
absent or weak foot pulses or other signs of limb ischaemia
Hx - smoking and vascular disease