LUMBAR/SIJ

Question 1

NSLBP

Answer 1

Red flags
- Claudia equina; bladder/bowel dysfunction, saddle numbness
- cancer; recent weight loss and PHX cancer
- infection/spinal abscess; IV drug abuse, fever, chills
- fracture; recent trauma or over 55 yo
- spondy; pn unrelieved by rest, phx repeated exn

lumbar facet joint
- local pn i facet joint area
- bending forward while lifting

disc related
- fwd bending
- slump test
- straight leg raise

Hyper mobility
Spondylolysis; unilateral pn
Spondylothesis; bilat pn

TX
- desentise pnful areas by what ct thinks helps
- reintroduce movements ct deems safe
- load, graded exposure
Mackenzie principle to find directional preference

PX
Glute bridge
Plank/ side plank
Bird dog, pelvic tilt

Question 2

Radicular syndrome LL

Answer 2

Radiculopathy; numbness, tingling, weakness down legs into foot
Radicular pn; more pn in legs than back
Spinal stenosis; relived by sitting, lying, pn with fatigue and clumsiness

TX
*NSAID pn relief
Mackenzie
Stenosis: posture control to reduce lordosis, pelvic titis , glute bridge

Question 3

SIJ // Pelvic girdle pn

Answer 3

Pregnant or mechanical overuse

Symptoms
- pn on SIJ and or pubic symphysis
intermittent pn
resting decrease pn,
Pn unequal weight bearing

SIGNS
SIJ pn- positive cluster lasletts
Pubic symph; Pos active straight leg raise, pn palp

TX
Self resolving
Pelvic belt
Avoid SL, split stance, rotation

Ex px
Bird dog, pelvic circles, cat cow,
Mobility-Stretch adductor, ham, glute , HF
Strength muscles that support pelvis ( adductor and obliques glutes ect )