Intro to Spine (2) Flashcards by Victoria Caridi

evaluation algorithm

CHARTS

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CHARTS

chief complaint

history

asymmetries of bony landmarks

range or motion/mobility

tissue tension

special tests

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what does the chief complaint and history include

intake forms

what’s my plan

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what do intake forms screen for–> CH

serious pathology

risk of chronicity

nociplasticity

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examples of intake forms

NPRQ

body chart

ODI/NDI

FABQ

pain diagram

VAS

PCS

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what does C/H do

categorize/classify

helps us develop a plan

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red flags –> 5 Ds

dizziness

dysarthria (talking)

dysphagia (swallowing)

diplopia (double vision)

drop attacks

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red flags –> 3 Ns

nausea

nystagmus (eyes flicking)

numbness (of face)

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red flag –> A

ataxia

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orange flags

assess risk of poor outcomes in tx

“red flags” for the mental health and psychological aspect of pt presentation

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examples of orange flags

alcohol addiction

PTSD

clinical depression

major personality dysfxn

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what do orange flags require

specialist referral

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SINSS

severity

irritability

nature

stage

stability

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what is SINSS referring to

the presentation of the symptoms

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severity –> SINSS

intensity of pain

impact on the pt’s life

presence or absence of night pain

pain meds needed

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how do we rate severity

min

mod

max

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min –> severity

0-3/10

no ADL limitations

no guarding

minimal meds

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mod –> severity

4-7

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max –> severity

8-10

max impacted ADLs

pain responses

irritability –> SINSS

magnitude of easing to aggerating factors

including amount and type, time it takes to ease

how do we rate irritability

min

mod

max

min –> irritability

2:1

agg to ease

ease quickly

max–> irritability

1-2

little tolerance to activity

slow recovery

sleep interrupted and meds needed

nature –> SINSS

type of pain

what system it may be associated w/

magnitude of other life factors

type of pain --> nature

nociceptive nociplastic neuropathic

stage --> SINSS

acute subacute chronic acute or subacute on chronic

acute --> stage

< 3 weeks

subacute --> stage

3-6 weeks

chronic --> stage

> 6 wks

stability --> SINSS

progression of the sxs improving, worsening, not changing, waxing and waning

what is a possible tool for pain pattern recognition

pain radar plot

building a "case"

after chief complaint and history are taken red/orange/yellow flags additional findings absence of specific dx

after chief complaint and history are taken --> building a "case"

intake forms are filled out able to rule out red & orange flags take proper notice of yellow flags

red/orange/yellow flags --> building a "case"

red/orange --> refer out to MD yellow flags --> CBT/F, remain active, etc

additional findings --> building a "case"

radicular syndrome (or specific dx) are considered

in the absence of specific dx --> building a "case"

therapist can assume nonspecific pain classify

hierarchy of athletic development

evaluation inflammation/pain management mobility motor control/work capacity strength power elastic strength speed

evaluation --> hierarchy of athletic development

classification of... -position & mobility deficit -motor control & power deficit

inflammation/pain management --> hierarchy of athletic development

rest activity modification modalities as needed meds as indicated

mobility --> hierarchy of athletic development

attain repeated motion joint mob/manip soft tissue mob active ROM exercises pin and stretch trigger point release massage

motor control/work capacity --> hierarchy of athletic development

muscle activation exercises motor control training strength development

strength must attain --> hierarchy of athletic development

muscle activation exercises motor control training strength development

strength includes --> hierarchy of athletic development

ability to exert force most basic physical quality relationship w/ power and speed

strength is the --> hierarchy of athletic development

foundation of athletic performance

power and elastic strength --> hierarchy of athletic development

assimilation of movement strength, power, elastic strength fxnal movement patterns

tx key concepts

control pain first mobility trumps stability always work you way up the "pyramid" regardless of the category

what if the pt presents w/ stability/motor control deficit

clear mobility above and below