Lumbar and Sacroiliac issues

Question 1

what is lumbar facet syndrome

Answer 1

Overrideing of facets of adjacent vert whereby the intravertebral foramen are narrowed from sup to inf

Question 2

innervation of facet joints

Answer 2

medial branch of PPR

each innervates atleast 3 lvls

Question 3

where is the highest facet joint OA

Answer 3

L4/L5

Question 4

types of lumar facet irritation (3)

Answer 4

1. Traumatic- inflammation of capsul
2. Pathological- degenerative thinning of IVD
3. Postural- Damage to the structures of LB due to excessive flexion

Question 5

What are the theories for the etiology of lumbar facet j syndrome (4)

Answer 5

1. Facet synovitis/ Hemarthrosis- awk movement
2. Facet motion restriction- stiffness of joints
3. Facet mechanical lock- synovial j locks
4. facet painful lock- entrapment of synovail capsul

Question 6

pain presentation of lumbar facet j syndrome (3)

Answer 6

1. rot or compressive sprain
2. Unusual activity (gardining, moving furniture etc)
3. recurrence due to minor episode of trauma(bending over sink, picking up pencil)

Question 7

are radiographs needed for lumbar facet j syndrome

Answer 7

usually not needed unless for trauma

Question 8

what is thoracolumbar syndrome

Answer 8

Maignes syndrome

-Lesion site is t12/l1 post facet joints that refers pain to cluneal nerves of t12,l1,l2

Question 9

what are the syndromes that cause refered pain in back (4)

Answer 9

1. lumbar facet j syndrome
2. thoracolumbar syndrome
3. sacroiliac j syndrome
4. myofascial pain syndrome

Question 10

when does fibrosis occur in the Si joint

Answer 10

• 50% of 50yolds will have fibrosis

- Complete fusion (ankyolsis) is rare and occurs in ppl 60-70

Question 11

what is the incidence of Si

Answer 11

20%

Question 12

what muscles can influence the Si joint

Answer 12

• piriformis
• glute max
• iliopsoas
• ql

Question 13

what are the two tests that should be done first in an si issue (which has most sensitivity and specicifity)

Answer 13

distraction and thigh thrust (if both are + then it is, if not go on to compression test)

sensitivety- thigh thrust
specifity- distraction

Question 14

what is the arthrokinetic reflex theory

Answer 14

Mobility (thru manipulation/exercise/mobalization) activates musculature around the joint leading to balance

Question 15

What is symphysiolysis and treatment

Answer 15

• during preg symphysis can shift so that pubic bones are not aligned
• can be treated infirectly with mobs/ manipulation

Question 16

what is coccydynia and the treatment of it

Answer 16

• pain in coccyx region or deep squat (sacrotuberous lig)
• can have mechanical causes (fall, childbirth) or nonmech (cancer etc)
• internal coccyxn manipulation/mob
• exercise

Question 17

Prevelence of Myofascial pain syndrome

Answer 17

as high as 63%

Question 18

what is myofacial pain syndrome

Answer 18

sensory, motor or autonomic symptoms caused by myofascial trig points

Question 19

What is a myofascial trig point and what are its 2 presentations

Answer 19

-hyperirritable spot in muscle that is associated w a hypersensitve palpable nodule

Active- always tender, prevents fulll rom etc

Latent- painful only when palpated

Question 20

what is the most common myofascial cause of LBP

Answer 20

Quadratus lumborum syndrome