LBP Flashcards
What is LBP?
Pain in the lumbar spine or sacral areas
Pain lasting less than how long is considered acute?
six weeks
Pain lasting between what lengths of time is classified as sub-acute pain?
6 weeks to 3 months
Chronic pain is defined as pain lasting longer than how long?
3 months
True or false: spinal manipulations is one of the few procedures that demonstrably improves outcomes for acute LBP without radiculopathy
True
What is the best preventative measure to take against LBP?
Exercise
90% of cases of LBP resolve within what time frame?
six weeks
50% of patients with radiation pain, symptoms resolve within what time frame?
one month
What percent of pts with LBP will have recurrent episodes within two years?
60-80%
The highest prevalence of LBP are in what age group?
45-64
What percent of LBP cases have an unknown etiology?
85%
What type of lumber SDs usually cause pain?
type II
What type of sacral SD typically produces pain?
BSTs or unilateral sacral flexions/extensions
What hip problems typically cause pain?
Innominate up-slips/down-slips
Situations where L5 and sacrum rotate in the (same/opposite) directions usually cause pain.
Same
True or false: bilateral extensions of the sacrum causes pain, but not usually flexions
False–both cause pain
True or false: short leg/pelvic tilt syndrome commonly cause pain
True
What are the three most common sacral causes of LBP?
BSTs
Unilateral sacral flexions
Innominate upslip
True or false: bilateral extensions/flexions of the sacrum are common causes of LBP
True
What are the three main reasons LBP may become chronic?
- Lack of specific diagnosis
- Lack of treatment for a specific SD
- Failure to recognize and treat strain patterns
What is the diagnostic process? (5)
- H&P
- rapid, then specific structural exam
- Red flags
- labs/radiology
- OMM
True or false: you only need one element of TART to diagnose a SD, but the more there are, the more significant the SD
True
When are you done treating LBP? (3)
- Pain is gone
- SDs are gone
- Pt has been in CCP for two visits, and you have treated them for it
Long standing SDs in the low back may lead to what?
Disc pathology
Facet arthritis
Stenosis
What is the most common SDs of the back in patient 20 yo and younger?
SDs of the L-spine, sacrum, and pelvis
What is the most common SDs of the back in patients 21-45?
SDs of the L-spine, sacrum, and pelvis
What is the most common SDs of the back in patients 46-65?
SDs of the L-spine, sacrum, and pelvis
What is the most common SDs of the back in patients 65+?
SDs of the L-spine, sacrum, and pelvis
What is the most common mechanical disorder of the spine?
Muscle strains
What is the more common type of BST: right on left, or left on Right?
Right on left
Which is the more common, right unilateral sacral flexion, or left unilateral sacral flexion?
Right unilateral
Which is more common: right up-slip or a left up-slip?
Right
Which is more common: right on right FST, or a left on left RST?
Right on right
How common are unilateral sacral extension? How painful are they?
really uncommon, but very painful
Running on an uneven surface = what SD?
Innominate up/down-slips
Sleep cycle disturbance d/t LBP is usually associated with what SD?
Type II
True or false: most of the SDs that cause pain are CCP
True
Pain preceded by fast extension of the spine = what SD?
Type II SD of the lumbar spine
How long does it take for an upslip to present with pain?
Few days
What is the problem with short leg/pelvic tilt syndrome?
Is not a SD, but leads to them
What muscles should be strengthened to prevent SDs of the spine?
Core
What are the steps of the diagnostic treatment process for SDs?
- History
- PE
- Rapid structural screen
- Structural exam
- Red flags
- Order stuff
- OMM
True or false: the more elements of TART you have, the worse the SD
True
What are the 10 steps of the rapid structural screen?
- Gait
- St flexion
- Seated flexion
- Spinal sweep
- Vertebral TTP
- Paraspinal musculature
- Rib sweep
- Respiratory rib motion
- Rib TTP
- Supine body asymmetry
When do you know that you no longer need to treat the patient with OMM, besides loss of pain and lack of SD that cause pain.
The patient has been in CCP for two visits in a row, and you have treated them for it.
What are the objective findings that indicate that a patient has resolved their SD? (5)
- Standing/seated flexion is negative
- Sphinx test is negative
- normal spinal curves
- Paraspinal muscles with normal tone
- Supine body in neutral