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37 y/o male comes to physician 2 days after sudden onset of severe low back pain. The pain began when lifting heavy boxes. He is otherwise healthy and not taking and medications. Exam shows paraspinal muscle tenderness and spasm. After 5 days of bed rest and oxycodone therapy, his back pin resolves. Which of the following measures is most likely to prevent a recurrence of his symptoms?
A) Exercise program
B) Use of back brace
C) Spinal manipulation
D) NSAIDS
E) Use of muscle relaxants
I think its A or D... anyone?
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I was debating between DDD & AAA. After giving the 2nd look to the Q I think AAAA would make a better choice & NSAID don't think have any Preventive role. Silly mistake.
You are right Dream, as always
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The main goal of physical therapy in persons with acute back pain is not to increase strength but to achieve adequate pain control. No benefit has been demonstrated for strengthening exercises in persons with acute back pain
The spine should be stabilized using strengthening of segmental muscles followed by the prime movers of the spine (ie, latissimus dorsi, abdominals, erector spinae). Muscle groups should be strengthened in a neutral position to decrease tension on ligaments and joints; this position allows balanced segmental forces between the disks and the zygapophyseal joints and maximizes functional stability with axial loading.
In a 2004 multicenter randomized trial, patients who were trained in exercises that matched their directional preference (DP) were more likely to achieve immediate, lasting improvement in pain compared with patients who received nondirectional treatment or opposite directional treatment.11 Patients using DP exercises were found to have a 3-fold decrease in medication usage. The idea of patient-specific exercises in managing LBP is recognized as controversial by the authors. Using DP to guide patients may improve outcomes in pain, function, and treatment satisfaction.
, i'm not sure about the answer here, but by elimination dont think that Nsaid and or mscle relaxant may prevent recurrence, physical therapy seems a good option.