Exam 2 - Back pain and epicondylitis Flashcards
What mneumonic can be used to determine the cause of lower back pain? What does each letter stand for?
V: vascular (aortic aneurysm, hemorrhoids)
I: inflammatory (herpes zoster, ovarian abscess, osteomyelitis)
N: neoplasm (mets, ovarian cyst, endometriosis)
D: degenerative (osteoarthritis, osteomalacia, spondylosis)
I: intoxication/idiopathic (gout, Paget’s)
C: congenital or acquired (herniated disk, scoliosis, posture)
A: autoimmune (rheumatoid spondylitis)
T: trauma (fracture, herniated disk)
E: endocrine (dysmenorrhea)
What is lumbar spinal stenosis?
Foraminal narrowing that causes nerve root to come out - impinges and causes inflammation
Symptoms of lumbar spinal stenosis
- Radicular pain
- Gluteal symptoms
How would the provider determine the level of lumbar spine stenosis on a patient?
Follow the dermatome map
What test could the provider perform to determine if the patient has lumbar spine stenosis?
- Lie patient down on stretcher or bed
- Straight leg raise
- If there is pain, suspect nerve impingement/radiculopathy
Lumbar spine stenosis management
- Limit activity
- Recommend PT
- NSAIDs
- Trial of steroids can be helpful
What imaging would be helpful in determining the level of lumbar spine stenosis?
MRI
What is lateral and medial epicondylitis often referred to as in laymans terms?
Lateral: tennis elbow
Medial: golfer’s elbow
What causes lateral/medical epicondylitis?
Repetitive use injury - causes inflammation
Patient presentation with lateral/medial epicondylitis
- Insidious elbow pain
- Tenderness over muscle tendon
- Pain on palpation
What test can the provider perform to assess for lateral/medical epicondylitis?
Resisted extension of wrist
- Pain is diagnostic
Lateral/medial epicondylitis management
- Tends to get better with rest
- NSAIDs
