Low Back Pain✅

Question 1

Information collected during Ax
(observation, palpation, ROM, Gait)

Answer 1

Observation
willingness to move/sit/change position
Standing; asymmetry, spinal deformity, muscle tone/bulk
Lordosis / kyphosis / scoliosis, skin changes

Palpation
bone processes
Midline and paraspinal muscle tenderness and spasm
Pain rating / sensation disturbance

Active ROM

Gait pattern

Question 1

Etiology of LBP causing nociceptive pain

Answer 1

Etiology of LBP:
- Muscle Strain
- Ligament tear (sprain)
- Injured vertebrae
e.g. collapsed vertebra
- Degenerative disc disease (localized pain)

SSx
- Nociceptive pain (sharp, aching, or throbbing)
- Localized aching sensation

Question 2

Special test for low back pain

Answer 2

Neurologic Examination (L4, L5 & S1)
Straight Leg Raise (SLR) & Cross SLR
Lasègue’s Test

Question 3

Etiology of LBP causing neuropathic pain

Answer 3

Etiology of LBP
- Radiculopathy神經根病
- Nerve root irritation or impingement 夾擠 due to adjacent structure
- displacement or malalignment
e.g. Sciatica坐骨神經痛:
irritation/impingement of sciatic nerve due to protrusion of herniated disc 椎間盤突出

SSx
- Neuropathic pain
- Radiating pain with cutaneous numbness (superficial pain)
- Burning sensation/ electrical shock under more severe condition (deep pain)

Question 4

Bed mobility advice / bed positioning

Answer 4

Bed mobility advice:
Use of the logroll technique to maneuver; must keep the back straight and tighten the abdominal muscles to support the back

bed positioning:
supine: place a pillow under the knees to reduce strain on
the lower part of the back and help maintain a balanced lower back position

side lying: place a pillow between the knees to prevent the hips from collapsing in toward the bed and twisting the lower part of the back