Lumbar/Sacral Conditions Flashcards
Lumbar facet syndrome- Sx/px/POM
S/s- dysfunction in joints that creates referral pattern. Repetitive lifting, bending, high impact etc
px- Kemps (w referral), localized LBP, ss reproduced w palpation, Neuro WNL, painful in extension
POM- conservative
Lumbar sprain- ss,px,pom
ss- hx of trauma, better w rest, locl pain w motion
px- decreased rom,prom,rrom due to pain, neuro WNL
POM-conserve
Si joint dysfunction
ss- localized pin (one side>other), trauma/long posture, transitions difficult, relieved w flex
px- SI tests +ve, Neuro WNL
POM- conserve
Disc Hern
ss- localized lip, numbness/tingling/lack of sensation in thigh etc (Leg>back), typically one sided, antalgic posture
px- flex painful, Disc tests +ve, decreased DTR, dejerines triad
POM- conserve
Spondylolisthesis
ss-repetative extension pos
px- possible hyperlordosis, repeatable catch/clunk w lumbar ROM, L5 mc
POM- conserve w/ focus on core strengthening
types of spondylolisthesis (5)
Isthic- stress fx in the pars
Degen- can cause lat stenos
Dysplastic- congenital defect in facet
Traumatic
Pathologic- secondary to cancer
Spinal stenosis- ss, px, pom
s/s
central- BL neuro symptoms, shopping cart sign, relief w flex forward
Lat- unilateral neuro symptoms, relief with lat bending away
px- neuro symptoms, extension painful and reproduce neuro
pom- conserve w neuro consult if not responding
Cauda equina ss, px, pom
ss- BL leg symptoms and numbness around anus and reproductive organs, loss of bowel or bladder control (urinary retention)
px- loss of anal wink, loss of sensation
POM- referral to ER via ambulance
arom l/s: Flex, Ext, Lat, Rot
flex- 70
ext-30
lat- 30
rot- 30
Lumbar DJD
ss- slow developing dull, achy joint pain following use. Morning stiffness better with mild activity and rest, worse w excessive, prior trauma
px- motion limited
Pom- conserve
