Lumbar CPGs Flashcards
LBP w/ mobility deficits
TBC
Manipulation
LBP w/ mobility deficits
clinical findings
< 16 days from onset of pain
Low back, buttock, or thigh pain (proximal to the knee)
Restricted lumbar ROM and segmental mobility
Symptoms reproduced with provocation of involved lower thoracic/lumbar/SI segments
LBP w/ mobility deficits
treatment strategies
Manual therapy/manipulation
Spinal mobility exercises (DP, ROM, etc.)
Ther ex addressing movement coordination, strength, and endurance deficits
Patient education encouraging an active lifestyle
LBP w/ movement coordination deficits
TBC
Stabilization
LBP w/ movement coordination deficits
clinical findings
Recurring LBP and/or related lower extremity pain
Aberrant movements and pain during initiation or mid-range spinal movements
Pain with provocation of associated lumbar segments
Positive prone instability test (PIT)
LBP w/ movement coordination deficits
treatment strategies
Neuromuscular reeducation/dynamic muscular stability in mid-range positions
Manual therapy and ther ex addressing t-spine, ribs, or hip mobility deficits
Ther ex for trunk and pelvic muscle strength/endurance
Community/work reintegration training for pain management strategies
LBP w/ related (referred) LE pain
TBC
Specific exercise and traction
LBP w/ related (referred) LE pain
clinical findings
Acute LBP and associated (referred) LE pain
Symptoms worsen with flexion activities and sitting
Lateral trunk shift
Reduced lumbar lordosis
Centralization of symptoms with specific postures or repeated movements
“responder” in McKenzie
LBP w/ related (referred) LE pain
treatment strategies
Ther ex, manual therapy, or traction that promotes centralization of symptoms
Improve lumbar extension mobility (prone press up)
Shift correction
Patient education for positions that promote centralization
LBP w/ radiating pain
TBC
Specific exercise and traction
LBP w/ radiating pain
clinical findings
Radiating pain in LE
LE paresthesias, numbness, weakness
Positive SLR or slump test
Nerve root involvement (DTR, myotomes, dermatomes, SLR)
Difficulty finding position of comfort
LBP w/ radiating pain
treatment strategies
Manual or mechanical traction
Nerve mobility exercises
Patient education for positioning that reduces train or compression to nerve root
Manual therapy to mobilize articulations and soft tissue surrounding involved nerve roots
Acute or subacute LBP w/ related cognitive or affective tendencies
clinical findings
2+ responses to mental health screen
Affect of individual with depression
High FABQ and pain catastrophizing scores
Behaviors consistent with anxiety and fear
Acute or subacute LBP w/ related cognitive or affective tendencies
treatment strategies
Refer to mental health provider
Patient education and counseling
Progressive exercise and return to activity
