LBP Flashcards
If pt complains of increased pain after sitting for 15+ minutes, you might think?
Piriformis Syndrome
Paresthesias down posterior aspect of thigh due to proximity to sciatic nerve
What SDs are common with piriformis syndrome?
Ipsilateral hip external rotation SD
sacrum is rotated anteriorly towards ipsilateral side on a contralateral oblique axis (sacral torsion)
What SD is commonly associated with psoas syndrome?
L1 and L2 flexed rotated towards affected psoas
L5 extension
TPs ipsilateral iliacus and contralateral piriformis
Short leg syndrome is associated with what SDs?
Lumbar spine SaRt the side of the lower sacral base
Innominate rotated anteriorly on side of short leg, or rotated posteriorly on side of long leg
Pelvic side shift to the side of the longer leg
Foot on longer leg pronated with internal rotation
How do we treat short leg syndrome?
tx SD in area (first)
exercise stretching of asym muscles
heel lift therapy (if discrepancy is greater than 5mm)
What SDs are seen in spondylolysis/spondylolisthesis?
Psoas spasm or inhibition
Iliacus dysfunction
Flexed upper lumbar dysfunction
Sacroiliac/sacral torsion dysfunction
Innominate dysfunction
What OMT tx should not be done for spondylolysis/spondylolisthesis?
HVLA
tx with indirect and soft tissue
How do you dx spinal stenosis?
MRI
Contrainindications of OMT
HVLA in low back pain from vertebral tumor or cancer metastasis to spine
HVLA with history of osteoporosis
HVLA for acute lumbar disc herniation (relative contraindication)
Most types of direct treatments for compression fracture (other than direct MFR)
HVLA in acute phase of rheumatoid arthritis affecting lumbar spine