LBRLP Activity Flashcards
Indications to use traction
- Hard neuro signs that you can’t centralize with usual stuff
- Every other thing I try makes them worse
If pt comes in with DJD in Lumbar spine and they have leg pain below calf, what is calf pain?
What do the neuro sx indicate?
it’s not just joint, but is from “nerve root” compression
If pt comes in with DJD in Lumbar spine and they have leg pain below calf…
Why is traction useful in this case?
- decrease pressure and compression on osteophytes (?)
- relieving the irritation/inflammation/swelling around the nerve root
What should be done between traction sessions?
- want to augment results
minimizing agg factors and mechanical stressors you know are going to make the nerve root unhappy
Teaching hip hinging
- start quadruped and show him what it is
- progress to tall kneeling
- then standing
Why would you not want to start teaching hip hinging in standing?
too difficult to isolate hip motion and not involve the spine
Why might lumbar rolls not be the best thing to use for a lot of pts?
- great in theory, not in practice
- takes more education than just placing it behind you
- use your judgment, be realistic
Choosing where to start with extension progression (supine or standing)
- depends on how much centralization you get with both movements
- if you get it in standing, don’t need to go prone
- more difficult to do during the work day
LBRLP algorithm: high score on LANSS
- indicates central sensitization/chronic pain
- need something else
LBRLP algorithm takes into account these factors
- LANSS score
- hard neuro signs
- neurodynamics
LBRLP algorithm: hard neuro signs present
what category?
what is the priority?
- denervation category
- priority is to find something that reduces sx
LBRLP algorithm: no hard neuro signs
go to neurodynamic testing
LBRLP algorithm: (-) neurodynamics?
MSK category like somatic referred pain causing leg pain
