2 Low Back Pain

Question 1

What is low back pain?

Answer 1

pain between TL junction and LS junction OR pain in SI/sacral areas

Question 2

Acute low back pain?

Answer 2

Acute:

Question 3

Sub-acute low back pain?

Answer 3

> 6 weeks,

Question 4

Chronic low back pain?

Answer 4

> 3 months

Question 5

What improves outcomes for acute LBP w/o radiculopathy?

Answer 5

spinal manipulation, apparently

Question 6

What factor decreases risk of LBP?

Answer 6

exercise regularly 3-4x/wk

Question 7

Describe timeframe for resolution of acute LBP

Answer 7

resolved in 6 wks in 90% of cases

Question 8

Describe timeframe with radiating pain

Answer 8

resolved within 1 month in 50% of patients

Question 9

What percent of patients have recurrence? Why?

Answer 9

60-80% of patients, theoretically due to unresolved somatic dysfunction

Question 10

Unfortunate consequences of long-standing vertebral SD?

Answer 10

disc pathology, facet arthritis, stenosis d/t increased wear and tear

Question 11

Age w/ highest prevalence of LBP?

Answer 11

45-65 yo

Question 12

Which SD’s produce pain?

Answer 12

• Type II SD in lumbar vertebral segment
• Backward sacral torsion
• unilateral or bilateral sacral flexions/extensions
• innominate up-slips
• short leg
• L5 sacrum in same direction

Question 13

Which of the follow is not one of the 5 most common LBP SDs at DMU?

• unilateral sacral extensions
• innominate down-slips
• Backward sacral torsions
• unilateral sacral flexions
• forward sacral torsion

Answer 13

downslip.

Question 14

why might LBP become chronic? (3)

Answer 14

lack of mechanical diagnosis

lack of definitive treatment for SD

no treatment of complicated strain patterns

Question 15

What is the diagnostic process for LBP?

Answer 15

history
PE
RSS
detailed structural exam
RED FLAGS
Labs/imaging
OMM

Question 16

How do you know when you are done?

Answer 16

no more LBP, tolerate normal activity

SD that produce pain are gone

pt has been in CCP for 2 visits in a row

Question 17

What objective signs tell you you’re done?

Answer 17

Standing flexion is negative
Seated flexion is negative
Sphinx is negative
Spinal sweep shows "normal" AP curve
Paraspinal muscles "normal" tone
Supine posture is neutral