Low back pain Flashcards
Prevalence of low back pain world wide
18.3%
Criteria of acute low back pain
<12 weeks, high likelihood to resolve, little to no management required
Criteria of chronic low back pain
> 12 weeks, high risk for loss of function, treatment resistant
Risk factors for low back pain
lifting weight at work, smoking, depression, obesity, inactivity
Protective/preventive factors
regular exercise alone, education with exercise
Primary causes of low back pain
mechanical, visceral, nonmechanical
Etiologies of visceral low back pain
GI organs, abdominal aorta, renal, GU organs, endometriosis
Etiologies of nonmechanically induced low back pain
neoplasm, infection, inflammatory
Most common mechanical etiologies of low back pain
sprain/strain/overuse, piriformis syndrome, psoas syndrome, short leg syndrome
strain
injury to muscle
sprain
injury to ligament
pain pattern of sprain/strain
aching pain over injured structure
Etiology of piriformis syndrome
hypertonic piriformis muscle, nerve entrapment of sciatic n.
Origin piriformis
anterior sacrum
Insertion piriformis
greater trochanter
What muscles does the sciatic n. pass between?
superior gemellus and piriformis
pain pattern piriformis syndrome
aching/burning pain in gluteal region, paresthesia down posterior thigh
Etiology psoas syndrome
chronic hypertonicity of psoas muscle
origin psoas
T12-L4
Insertion psoas
greater trochanter
pain pattern psoas syndrome
patients will flex lumbar spine, pain originates at thoracolumbar region, worsens with extension
diagnosis of psoas syndrome
palpation of muscle, Thomas test, pelvic side shift resolves with manipulation
pelvic side shift
laterally translate innominate to test for preference
etiology of short leg syndrome
anatomic leg length discrepancy creates sacral base unleveling
pain pattern short leg syndrome
similar to overuse syndrome, pain in affected structures above low back