Take a few back pain quizzes; However, I must warn you — your answers could be so wrong! Because the back is so complex, it’s extremely difficult to tell exactly where’s the origin/source or cause of your back pain. In fact, to prove this, I would like you to take your best shot at these few (clinical vignette type) back pain questions I have come across,during one of my readings on back pain.

Scenario 1
A 45 year old man(driver)who was recently a victim of a motor vehicle accident was experiencing back pain a day after the accident. On the 10th day,he decided to see a doctor, because he was still feeling pain. In addition, he notices that when we tries to extend or bend his neck laterally, he has been experiencing crunching. His physical examination result reveals no sign of neurological deficits. There were also no areas of tenderness or spasm, neither were there any abnormalities in the lateral bending, extension, and flexion of the neck.

1. Which of the following is the most likely cause of his pain?


Human Anatomy Banner


Scenario 2
A 65 year old Restaurant cook was presented to the ER with low back pain that exacerbated with prolonged standing and also with exercise. The patient shares that for the last several months, the pain usually surfaces with walking less than a block, and radiates to the buttocks, but normally lightens after sitting for several minutes. Patient admits having a long history of back pain. His physical examination result reveals no neurological deficits nor abnormal bilateral straight-leg raising maneuvers. Patient’s peripheral pulses are also strong and equal bilaterally.

2. Which of the following is this Patient's most likely diagnosis?


Scenario 3
A 43 year old man states that after lifting some heavy equipment on a construction site he has been working, he felt this sudden onset of severe back pain. He describes the pain as being in his right lower back spreading down to the back of his right buttock to the knee area. He experiences no bowel or bladder dysfunction, and the pain is less severe with best rest. The following are the results of his physical examination:
1)Tenderness in his lumbar area with palpation
2)Straight-leg maneuver with right leg worsens his back pain at 80 degrees, and with the left leg, it causes pain.
3)No abnormality in sensation, strength, and reflexes

3. Which of the following is the most likely cause of his back pain?


Scenario 4
A 83 year old lady complains of recurrent back pain in her lumbar (lower back) region which radiates to her buttocks. She states that the pain on the left side is not as severe as that on the right. When she sits or walks, the pain gets worse. She says she has not been experiencing any bladder dysfunction.

Her physical examination reveals the following:
1)Diminished sensation and decreased reflexes of the right lower limb
2)Straight-leg raising and cross-leg raising tests are positive for reproduction of right lower limb symptoms
3)No signs of spinal deformaties

4. Which of the following is the most likely cause of her back pain?

Source: Pre-Test,Physical Diagnosis:5th Ed; Reteguiz J.

Comments or questions are welcome.

* indicates required field

Leave a Reply