1. The lifetime prevalence of back pain exceeds what percentage in most industrialized countries? a. 20-30% b. 40-50% c. 60-70% d. 70-80%

2. Disability from low back pain is second only to the common cold as a cause of lost work time and is the most common cause of disability in persons under age 45. True False

3. Most back pain is self-limiting, with 50-60% of patients showing improvement regardless of treatment. True False

4. What percentage of patients with low back pain are hospitalized? a. 3% b. 10% c. 25% d. 40%

5. What percentage of patients have surgery as a result of a given episode of low back pain? a. 0.5% b. 1.0% c. 3.5% d. 10%

6. What percentage of patients are considered totally disabled from chronic low back pain, and what percentage are considered partially disabled in the U.S.? a. Total: 2%, partial: 5% b. Total: 5%, partial: 15% c. Total: 10%, partial: 25% d. Total: 25%, partial: 40%

7. Although there is a high remission rate, the recurrence rate for low back pain is also high. What percentage of patients with acute low back pain will suffer at least 1 additional episode which will last longer and produce more severe symptoms? a. 30-40% b. 40-50% c. 50-60% d. 60-70% e. 70-80%

8. Name at least 5 (out of the 18) diagnostic and prognostic red flags in cases of low back pain.

9. Describe what the following maneuvers specifically test for, and how to perform them. a. Straight leg raise

b. Crossed straight leg raising test (Fajersztajn test).

c. Patrick’s Test

d. Sacroiliac provocation test

1. What do the following findings on physical exam in a patient with low back pain signify? (please be specific) a. Absence of patellar reflex

b. Presence of heel drop

c. Absence of the Achilles reflex

d. Weakness of the extensor digitorum longus and extensor hallucis longus.

1. In general, most patients with low back pain will recover (90%) in 4-8 weeks, and no laboratory or diagnostic procedures are usually recommended for the routine workup unless there are red flags present. Name 5 indications for obtaining lumbosacral (LS) radiographs.

2. Name 3 indications for CT or MRI.

3. What are the 3 primary goals of management of low back pain?

4. Prolonged bedrest has proven to be detrimental, as it causes deconditioning, and should be limited to only 5 days. True False

5. Muscle relaxants have been studied and found to be better than placebo in both acute and chronic muscle spasm. True False

6. Ultrasound should not be used if a disk herniation is suspected, especially if the patient had a previous laminectomy. True False

7. In a recent study, neither lumbar support nor education led to a decrease in low back pain incidence or sick leave. True False

8. In following a patient that has both back pain and sciatica, what things should they immediately call someone for?

9. What are the indications for emergent surgery in a low back pain patient?

10. What is cauda equina syndrome?