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OSIII > Low back pain > Flashcards

Low back pain Flashcards

1
Q

Prevalence of low back pain world wide

A

18.3%

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2
Q

Criteria of acute low back pain

A

<12 weeks, high likelihood to resolve, little to no management required

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3
Q

Criteria of chronic low back pain

A

> 12 weeks, high risk for loss of function, treatment resistant

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4
Q

Risk factors for low back pain

A

lifting weight at work, smoking, depression, obesity, inactivity

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5
Q

Protective/preventive factors

A

regular exercise alone, education with exercise

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6
Q

Primary causes of low back pain

A

mechanical, visceral, nonmechanical

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7
Q

Etiologies of visceral low back pain

A

GI organs, abdominal aorta, renal, GU organs, endometriosis

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8
Q

Etiologies of nonmechanically induced low back pain

A

neoplasm, infection, inflammatory

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9
Q

Most common mechanical etiologies of low back pain

A

sprain/strain/overuse, piriformis syndrome, psoas syndrome, short leg syndrome

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10
Q

strain

A

injury to muscle

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11
Q

sprain

A

injury to ligament

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12
Q

pain pattern of sprain/strain

A

aching pain over injured structure

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13
Q

Etiology of piriformis syndrome

A

hypertonic piriformis muscle, nerve entrapment of sciatic n.

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14
Q

Origin piriformis

A

anterior sacrum

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15
Q

Insertion piriformis

A

greater trochanter

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16
Q

What muscles does the sciatic n. pass between?

A

superior gemellus and piriformis

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17
Q

pain pattern piriformis syndrome

A

aching/burning pain in gluteal region, paresthesia down posterior thigh

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18
Q

Etiology psoas syndrome

A

chronic hypertonicity of psoas muscle

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19
Q

origin psoas

A

T12-L4

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20
Q

Insertion psoas

A

greater trochanter

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21
Q

pain pattern psoas syndrome

A

patients will flex lumbar spine, pain originates at thoracolumbar region, worsens with extension

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22
Q

diagnosis of psoas syndrome

A

palpation of muscle, Thomas test, pelvic side shift resolves with manipulation

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23
Q

pelvic side shift

A

laterally translate innominate to test for preference

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24
Q

etiology of short leg syndrome

A

anatomic leg length discrepancy creates sacral base unleveling

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25
Q

pain pattern short leg syndrome

A

similar to overuse syndrome, pain in affected structures above low back

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26
Q

pelvic side shift for short leg syndrome

A

lateral translation of pelvis away from short leg

27
Q

Treatment for short leg syndrome

A

heel lift therapy if discrepancy is >5mm or >1/5 inch

28
Q

Heel lift therapy process

A

add 1/8 or 1/16 inch every 2 weeks

29
Q

Prevalence of degenerative disc disease on radiographic finding

A

60-80% of adults > 49 yo

30
Q

Etiology of degenerative disc disease

A

degeneration causes stress and inflammation of nociceptors

31
Q

pain pattern of degenerative disc disease

A

nonspecific location

32
Q

Degenerative disc disease pain worsens with…

A

bending forward, sneezing, coughing

33
Q

Etiology spondylolysis

A

defect/stress factor of pars interarticularis

34
Q

Pain pattern spondylolysis

A

asymptomatic, pain is common at L5 vertebrae

35
Q

Spondylolysis pain worsens with…

A

hyperextension

36
Q

Diagnostic Xray image of spondylolysis

A

Scotty dog

37
Q

Etiology spondylolisthesis

A

anterior displacement of vertebrae secondary to bilateral pars defects

38
Q

pain pattern spondylolisthesis

A

nonspecific

39
Q

Risks of spondylolisthesis

A

age, bilateral spondylolysis

40
Q

Spondylolisthesis pain worsens with…

A

extension and activity

41
Q

Etiology of compression fracture

A

acute atraumatic fracture or chronic loss

42
Q

pain pattern of compression fracture

A

asymptomatic or acute lower mid thoracic/thoracolumbar junction pain

43
Q

Risks of compression fracture

A

age, osteoporosis, menopause, malignancy

44
Q

Compression fracture worsens with…

A

sitting, spine extension, valsalva maneuver, movement

45
Q

sciatica

A

symptom of numbness tingling pain in sciatic nerve distribution

46
Q

Etiology spinal stenosis

A

narrowing of neural foramen or central canal

47
Q

Pain pattern spinal stenosis

A

unilateral numbness and tingling, L4/L5/S1 nerve roots

48
Q

Spinal stenosis pain worsens with…

A

standing and walking

49
Q

Spinal stenosis pain improves with…

A

flexion, leaning forward, and sitting

50
Q

pain pattern herniated disc

A

typically between L4-L5 (L5 nerve root) and L5-S1 (S1 nerve root)

51
Q

pain pattern cauda equina syndrome

A

numbness and tingling in perineum, fecal/urinary incontinence, radicular numbness tingling or weakness

52
Q

Delayed treatment of cauda equina will lead to

A

permanent incontinence and disability

53
Q

Red flag symptoms of low back pain

A

progressive lower extremity weakness, saddle anesthesia/loss of bladder and bowel control, deep bone pain or unexplained weight loss, and fever/chills

54
Q

When should imaging not be ordered?

A

low back pain within first 6 weeks unless there is progressive neuro deficit

55
Q

Conservative methods of back pain management

A

reassurance, continue activity, avoid bed rest, muscle relaxers, antidepressants, physical therapy, OMM

56
Q

Greenman’s dirty half dozen

A

muscle imbalance, lumbar spine type 2 dysfx, short leg, sacral extension dysfx, innominate shear

57
Q

Invasive treatments for back pain

A

epidural injection, facet injection, radiofrequency ablation, decompression or fusion surgery

58
Q

Lumbar prone direct long lever–Rotation

A

stand opposite of PTP, grasp ipsilateral pelvis around ASIS; rotate lumbars sequentially up slightly superior to SD, hypothenar or pisiform on PTP and thrust after exhalation

59
Q

Lumbar longer lever–Rotation

A

stand opposite PTP, grasp ipsi leg above knee, rotate lumbars superior to SD, hand on named vertebra or one below SD

60
Q

Lumbar direct rotational-sidebending

A

localize sidebending by pulling on leg–posterior and lateral for type I and towards floor for type 2

61
Q

Prolotherapy

A

chemical or mechanical irritant to induce growth and formation of new fibro-elastic connective tissue

62
Q

Clinical suggestions of sacral base unleveling

A

uneven medial malleoli, knee height inequity

63
Q

Expected compensations in short leg syndrome

A

Lumbar spine bent away from short side, innominate rotated anterior on side of dysfx, superior pelvic sheer or posterior rotation of long leg, foot on long leg pronated with internal rotation

64
Q

X-ray measurement on postural scan for short leg syndrome

A

sacral declination–line of eburnation

OSIII (11 decks)

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