Lumbar Spine CPGs Flashcards
MCID for oswestry disbility index
10/100 or 30%
*higher score = greater disability
how many items on oswestry disability index
10
8 related to ADLs and 2 related pain
what rating do PT outcome measures have to back pain (ABCD)
A
If your pt with chronic back pain comes in and is wondering why they haven’t gotten imaging, what can you tell them?
According to the American College of Physicians, imaging is only indicated for severe progressive neuro deficits or when red flags are suspected. Routine imaging does not result in clinical benefit and may lead to harm.
*said in pt friendly language of course
What are the ICF classifications for LBP (treatment)?
1) Acute LBP
2) Acute LBP with leg pain
3) Chronic LBP
4) Chronic LBP w/ leg pain
5) Chronic LBP w/ movement control impairment
6) Chronic LBP in older adults
7) Post-op LBP
what are the ICF classifications for LBP rated as?
B
T or F: there has been an increase in chronic LBP
T
what two areas of pain are associated with the highest medical cost?
neck and low back
T or F: LBP is a leading cause of disability
T
prognostic factors for development of recurrent pain (3)
1 - history of previous episode
2 - excessive spine mobility
3 - excessive mobility in other joints
prognostic factors for development of chronic pain
1 - presence of symptoms below the knee
2 - psychological distress
3 - fear of pain, movement, reinjury or low expectations of recovery
4 - pain of high intensity
5 - passive coping style
yellow flags
psychological
blue flags
injured workers
black flags
social and financial issues
red flags
serious pathology
red flags for cancer (5)
1) hx of cancer
2) night pain or pain at rest
3) unexplained weight loss
4) >50 or <17
5) failure to improve
red flags for disk or vertebrae infection (4)
1) immunosuppressed
2) prolonged fever
3) hx of IV drug abuse
4) recent UTI, cellulitis, pneumonia
red flags for vertebral fracture (6)
1) corticosteriod use
2) mild trauma >50 y/o
3) >70 y/o
4) osteoporosis
5) recent major trauma
6) bruising over spine
red flags for abdominal aortic aneurysm (3)
1) pulsating mass in abdomen
2) atherosclerotic vascular disease
3) age >60
clinical findings for chronic LBP with movement coordination/control impairments
1) LBP or low-back related LE pain that worsens with sustained end range movements or positions
2) hypermobility with PAs
3) mobility deficits in lumbopelvic, thoracic, and hips
4) decrs trunk or pelvic region muscle strength
5) movement coordination impairments during functional activities
What are some treatments for acute LBP with or without leg pain?
1) exercise, especially trunk activation
2) mobs/manips
3) soft tissue mob for short-term relief
4) MDT
5) active education
T or F: natural history is favorable for acute LBP
T
What are some treatments for chronic LBP?
1) exercise - including trunk muscle strengthening and general exercise
2) joint mobs/manips
3) soft tissue mobs
4) dry needling (maybe)
5) neural mobs
6) PNE—active education
T or F: you should use mechanical traction for LBP
F
what are some treatments for post-op LBP
1 - general exercise training
2 - general education (post-op precautions, exercise, resuming physical activity)
