Low Back Pain

Question 1

Introduction

Answer 1

1 - Introduce Yourself
2 - Confirm for patients' details
3 - Explain the procedure
4 - Gain Consent
5 - Ask if they have any pain before starting

Question 2

Pre-procedure steps?

Answer 2

1 - Wash your hands

2 - Undress patient (or expose the back)

Question 3

Second steps?

Answer 3

Inspection

-Watch for Kyphosis or loss of lumbar lordosis

Then ask the patient to bend over (for scoliosis)

Question 4

Third Steps?

Answer 4

Palpation

1 - The middle of the spine
2 - Paraspinal muscles

Question 5

Fourth Steps?

Answer 5

Provocative Tests

L5 - S1
1 - Tripod sign (positive if both hands extend)
2 - Straight leg sign ( 30 - 60º)
3 - If positive, drop 15º, and dorsoflex the foot

L2 - L4
1 - Femoral Strech Test (positive if pain on the anterior thigh)

Question 6

Fifth additional test?

Answer 6

Neurological exam

1 - Motor exam (kick, dorsoflex and plantar flexion)
2 - Sensory
3 - Reflexes (L4 - Patelar, L5 - Hemstrings, S1 - Aquiles tendon)

Question 7

When are image tests, such as MRIs, needed?

Answer 7

When the neuro exam is altered.