Lumbar spine

Question 1

pt profile: age= females, local and chronic vague pain in back and leg, possibly bilateral. N/T and weakness of LEs.
Agg factors: extension, prolonged standing or walking, walking downhill, lying flat.
Ease factors: biking, sitting, squatting, flexion in general, walking uphill

Answer 1

spinal stenosis

Question 2

what diagnosis is this OE consistent with?
pain with SB toward involved side, ext. and ext + rot= painful, treadmill test= pain with downhill or level walking but can tolerate inclined walking

Answer 2

stenosis

Question 3

tx for stenosis

Answer 3

flexion exercises

stretch Hip flexors and hamstrings, traction into flexion, spinal stab., TA

Question 4

what is the diagnosis?
hx of PVD and atherosclerosis, pain in buttock and calf that is worse with inc. activity and with walking uphill but fine with walking level or downhill, eases with rest and ceasing activity, no real back pain. There are skin color changes, loss of hair growth, mm cramping, and lack of peripheral pulses at times

Answer 4

vascular claudication!

Question 5

dx associated with Z joint?

Answer 5

acute and chronic facet :)

Question 6

patient profile: sharp, unilateral pain, pain and tenderness with palpation, pain increases with SB and ext. history of an accident with sudden unguarded movement in a flexion/rotation kind of way

Answer 6

acute facet

Question 7

tx for acute facet?

Answer 7

unilateral PAs, traction, manips, address rotation/ SB impairments

Question 8

patient profile:
unilateral pain, less sharp than it used to be, stiff in AM, inc. pain with SB, rot, long history of the pain, aches with long periods of inactivity, improves with activity but then returns with avengance, eased with flexed posture, hx of trauma

Answer 8

chronic facet

Question 9

tx of chronic facet?

Answer 9

rotation, paivms, traction, manips

Question 10

patient profile:
started as just a back ache but now it hurts all the way down my leg and my leg hurts worse than my back. very limited ROM, SLR and slump are pos for pain.

Answer 10

acute nerve root

Question 11

S1 nerve root pain pattern

Answer 11

lat. thigh and lower leg and lateral border of foot

Question 12

L5 nerve root pain pattern

Answer 12

lateral hip, ant/lat thigh, anterior lower leg down accross to big toe

Question 13

L4 nerve root pain pattern

Answer 13

Lateral hip, ant. thigh and lower leg to shin

Question 14

L3 nerve root pain pattern

Answer 14

Lat. hip, anterior thigh

Question 15

tx for acute nerve root?

Answer 15

lumbar rotation

traction

Question 16

patient profile: proximal and distal symps, it used to be that my leg hurt worse than my back, but now my back hurts way worse than my leg. I can do more now than when it first started hurting. local thickness, stiffness of tissues. pain with OP

Answer 16

chronic nerve root

Question 17

tx for chronic nerve root?

Answer 17

unilateral paivms, rotation, traction, soft tissue