L/T spine Flashcards
Manip for LBP
Sx 35 IR, no sx distal to knee, Lumbar hypomobility
Spinal Stenosis
> 48 yo, pain relieved with sitting, pain exacerbated by standing, leg pain worse than back pain, bilateral
Lumbar TBCS categories
Extension, Flexion, Stabilization, Traction, Manipulation
what are yellow flags for LBP
personal mistaken beliefs re: pain and injury; ie: pain catastrophizing, anxiety/depression, elevated fear-avoidance, low self-efficacy
What are blue flags and black flags for LBP?
blue: related to workers
black: social/financial issues; ie. reimbursement incentives to remain disabled
cases where MRI for LBP is beneficial
compression of spinal cord, cauda equina or spinal nerve
What is a High Intensity Zone?
assoc with annular tear - may be a component of discogenic pain
What is a high T2 signal?
in and near vertebral end plate; may be assoc with pain from disc (Modic sign)
What is a clinical sign most indicative of discogenic pain?
centralization
Why is LBP often vague/diffuse in location?
sensory info from outer disc is carried both in the adjacent dorsal root as well as extra-segmentally through the sympathetic chain
Describe age-related changes in the IVD
similar to changes seen in articular cartilage and are not necessarily linked to pain
Why might a healing IVD be more sensitive to pain?
There may be an increased amount of tissue that is innervated which lowers the threshold to trigger nociceptors
Pts with DD can do what in the morning to decrease their pain/disability throughout the day?
avoid lumbar flexion for the first 2 hours of the day
