Low Back Pain Flashcards

1
Q
  • aching pain in the gluteal region
  • parasthesias that radiate down the back of the leg
  • worse after sitting > 15-20 mins
  • “wallet sign”
A

piriformis syndrome

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2
Q

actions of piriformis muscle

A

when hip is extended:

  • external rotation

when hip is flexed:

  • aBduction
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3
Q

straight leg raise test

A

(+) increased pain between 30°-60°

  • inicates lumbosacral radiculopathy d/t herniated disc or sciatic neuropathy
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4
Q

psoas syndrome

A
  • RLQ pain that radiates to the lower back
  • worse with standing
  • hypertonic psoas muscle
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5
Q

what SDs are commonly associated with psoas syndrome? (4)

A
  • L1-2 F, R towards the dysfunction (type 2)
    • If chronic, there may be a type 1 SD above and below the type 2 dysfunction
  • L5 E
  • TPs on ipsilateral iliacus
  • TPs on contralateral piriforms
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6
Q
  • midline low back pain
  • worsens as the day progresses
  • surgical Hx
  • difference in iliac crest heights
A

short leg syndrome

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7
Q

Chapma’s point on the iliolumbar ligament

A

colon

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8
Q

what SDs are commonly associated with short leg syndrome? (7)

A
  • iliolumbar ligament SD
  • sidebent towards the side of the high innominate
  • rotated away from the side of the high innominate
  • anterior innominate roation ipsilateral to short leg
  • posterior innominate rotation contralateral to short leg
  • pelvic side shift to the side of the longer leg
  • foot pronated and IR on longer leg
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9
Q

what are the reccomendations for heel lift therapy?

A
  • fragile
    • start 1/16”
    • add 1/16” every 2 weeks
  • flexible
    • start 1/8”
    • add 1/8” every 2 weeks
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10
Q

spondylolysis

A

stress fracture in the pars interarticularis

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11
Q

spondylolisthesis

A

stress fracture plus slidiung of vertebra

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12
Q

what causes spondylolysis/spondylolisthesis?

A

hyperlordosis d/t hyperextension and overuse

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13
Q

how does spondylolysis present in children?

A
  • usually asymptomatic
  • possible change in gait/posture
  • possible hamstring hypertonicity
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14
Q

what SDs are commonly associated with spondylolysis/spondylolisthesis? (5)

A
  • psoas spasm or inhibition
  • iliacus dysfunction
  • flexed upper lumbar dysfunction
  • sacroiliac/sacral torsion
  • innominate dysfunction
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15
Q

symptoms of disc herniation

A
  • pain in the buttock that radiates down the posterior thigh
    • straight leg test
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16
Q

causes of disc herniation

A
  • compression and/or rotational force
  • common with bending or lifting
17
Q

what is the most common type of spinal disc herniation?

A

posterolateral herniation at

  • L4-5 or L5-S1
18
Q

what OMT treatment is particularly helpful for disc herniation?

A

FPR, especially if symptoms of radiculopathy are present

19
Q
  • lower back pain radiating down bilateral posterior thighs
  • urinary and bowel changes
  • saddle anesthesia
A

cauda equina syndrome

20
Q
  • intermittent low back pain
  • worse with bending over and sitting down
  • improved with lying down
A

degenerative disc disease “wear and tear”

21
Q
  • low back pain
  • improves with sitting down or leaning over
  • worse with standing for long periods of time
  • numbness and tingling in posterior thighs
A

spinal stenosis

22
Q

causes of spinal stenosis

A

narrowing of the spinal canal

  • herniated or bulging disc
  • abnormal mass
  • osteophytes/bone spurs from OA
  • scar tissue from previous surgery
23
Q

central stenosis may result in ________.

A

neurogenic claudication

24
Q

25 modifier

A

separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service

25
Q

59 modifier

A

used for a distinct procedural service to indicate that 2+ procedures were performed during the same visit to different sites on the body

  • Ex. OMT + trigger point injections in the same visit