Lower back pain: Clinical (To be retired)
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Lower back pain: Clinical (To be retired)
Medicine and surgery
Allergy and immunology
Antihistamines for allergies
Glucocorticoids
Cardiology, cardiac surgery and vascular surgery
Coronary artery disease: Clinical (To be retired)
Heart failure: Clinical (To be retired)
Syncope: Clinical (To be retired)
Hypertension: Clinical (To be retired)
Hypercholesterolemia: Clinical (To be retired)
Peripheral vascular disease: Clinical (To be retired)
Leg ulcers: Clinical (To be retired)
Adrenergic antagonists: Alpha blockers
Adrenergic antagonists: Beta blockers
ACE inhibitors, ARBs and direct renin inhibitors
Thiazide and thiazide-like diuretics
Calcium channel blockers
Lipid-lowering medications: Statins
Lipid-lowering medications: Fibrates
Miscellaneous lipid-lowering medications
Antiplatelet medications
Dermatology and plastic surgery
Hypersensitivity skin reactions: Clinical (To be retired)
Eczematous rashes: Clinical (To be retired)
Papulosquamous skin disorders: Clinical (To be retired)
Alopecia: Clinical (To be retired)
Hypopigmentation skin disorders: Clinical (To be retired)
Benign hyperpigmented skin lesions: Clinical (To be retired)
Skin cancer: Clinical (To be retired)
Endocrinology and ENT (Otolaryngology)
Diabetes mellitus: Clinical (To be retired)
Hyperthyroidism: Clinical (To be retired)
Hypothyroidism and thyroiditis: Clinical (To be retired)
Dizziness and vertigo: Clinical (To be retired)
Hyperthyroidism medications
Hypothyroidism medications
Insulins
Hypoglycemics: Insulin secretagogues
Miscellaneous hypoglycemics
Gastroenterology and general surgery
Gastroesophageal reflux disease (GERD): Clinical (To be retired)
Peptic ulcers and stomach cancer: Clinical (To be retired)
Diarrhea: Clinical (To be retired)
Malabsorption: Clinical (To be retired)
Colorectal cancer: Clinical (To be retired)
Diverticular disease: Clinical (To be retired)
Anal conditions: Clinical (To be retired)
Cirrhosis: Clinical (To be retired)
Breast cancer: Clinical (To be retired)
Laxatives and cathartics
Antidiarrheals
Acid reducing medications
Hematology and oncology
Anemia: Clinical (To be retired)
Anticoagulants: Warfarin
Anticoagulants: Direct factor inhibitors
Antiplatelet medications
Infectious diseases
Pneumonia: Clinical (To be retired)
Urinary tract infections: Clinical (To be retired)
Skin and soft tissue infections: Clinical (To be retired)
Protein synthesis inhibitors: Aminoglycosides
Antimetabolites: Sulfonamides and trimethoprim
Miscellaneous cell wall synthesis inhibitors
Protein synthesis inhibitors: Tetracyclines
Cell wall synthesis inhibitors: Penicillins
Miscellaneous protein synthesis inhibitors
Cell wall synthesis inhibitors: Cephalosporins
DNA synthesis inhibitors: Metronidazole
DNA synthesis inhibitors: Fluoroquinolones
Herpesvirus medications
Azoles
Echinocandins
Miscellaneous antifungal medications
Anti-mite and louse medications
Nephrology and urology
Chronic kidney disease: Clinical (To be retired)
Kidney stones: Clinical (To be retired)
Urinary incontinence: Pathology review
ACE inhibitors, ARBs and direct renin inhibitors
PDE5 inhibitors
Adrenergic antagonists: Alpha blockers
Neurology and neurosurgery
Stroke: Clinical (To be retired)
Lower back pain: Clinical (To be retired)
Headaches: Clinical (To be retired)
Migraine medications
Pulmonology and thoracic surgery
Asthma: Clinical (To be retired)
Chronic obstructive pulmonary disease (COPD): Clinical (To be retired)
Lung cancer: Clinical (To be retired)
Antihistamines for allergies
Bronchodilators: Beta 2-agonists and muscarinic antagonists
Bronchodilators: Leukotriene antagonists and methylxanthines
Pulmonary corticosteroids and mast cell inhibitors
Rheumatology and orthopedic surgery
Joint pain: Clinical (To be retired)
Rheumatoid arthritis: Clinical (To be retired)
Lower back pain: Clinical (To be retired)
Anatomy clinical correlates: Clavicle and shoulder
Anatomy clinical correlates: Arm, elbow and forearm
Anatomy clinical correlates: Wrist and hand
Anatomy clinical correlates: Median, ulnar and radial nerves
Anatomy clinical correlates: Bones, joints and muscles of the back
Anatomy clinical correlates: Hip, gluteal region and thigh
Anatomy clinical correlates: Knee
Anatomy clinical correlates: Leg and ankle
Anatomy clinical correlates: Foot
Acetaminophen (Paracetamol)
Non-steroidal anti-inflammatory drugs
Glucocorticoids
Opioid agonists, mixed agonist-antagonists and partial agonists
Antigout medications
Osteoporosis medications
Assessments
Lower back pain: Clinical (To be retired)
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Transcript
Content Reviewers
Rishi Desai, MD, MPHContributors
Sam Gillespie, BSc
Evan Debevec-McKenney
Back pain can originate from the spinal cord, the nerve roots, the vertebral column, the surrounding muscles and ligaments, or even extra-spinal structures such as abdominal organs.
Most lower back pain is considered non-specific musculoskeletal back pain, and is due to strained muscles and ligaments in the back. But sometimes it’s due to a specific disorder, and these can be categorized into 6 groups: degenerative disorders, mechanical disorders such as disk herniation and lumbar spinal stenosis, infections such as osteomyelitis and spinal epidural abscess, spinal epidural hematoma, inflammatory disorders such as ankylosing spondylitis, and cancers, such as multiple myeloma.
Specific disorders are often identified with a thorough history, and to help remember some common clues there’s the mnemonic: “TUNA FISH”.
“T” is for trauma. “U” is for unexplained weight loss, which may suggest a cancer. “N” is for neurological symptoms, like sensory loss, pain, or weakness in the legs, loss of sensation in the perineal area - which is called saddle anesthesia - as well as bowel, bladder, or sexual dysfunction.
“A” is for age over 50, which increases the risk of cancer.
“F” is for fever, which may indicate an infection.
“I” is for intravenous drug use or an immunocompromised state, both of which also increase the risk of infection.
“S” is for steroid use, which can cause secondary osteoporosis and vertebral fractures.
And finally, “H” is for a history of cancer.
On physical examination there might be some clues that suggest a specific disorder as well.
For example, erythema might be due to an underlying infection or and inflammatory process like psoriatic arthritis.
On palpation, if there’s a midline, point of focal tenderness then that could be due to an infection, cancer, or fracture.
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