Ominous LBP Flashcards
What could be the cause of ominous LBP?
- Known cancer
- Steroid/anticoagulant
- Elderly age
- drug
What will be on the PE?
- Excruciating pain
- No better with rest
- Fever
- Weight loss
What are the PE components of LBP
- Observation
- ROM
- Palpation of spine and para spinal structures
- Traction
- Neurological exam
If the patient is sitting comfortably what does that rule out?
Mechanical back pain
*sitting is the most uncomfortable position
*supine is more comfortable
*patient will be moving around
*sprawling position
What are the traction maneuvers?
- Straight leg raise (SLR)
+radicular pain when leg is raised between 30-60 degrees
+if the symptoms occur while raising the opposite leg - Flip sign (SLR in sitting position)
+ = herniated disc
What causes a + Babinski
Something wrong with the CNS
*will never be bc of raduculopathy
What is the neurological exam for LBP?
- Knee and ankle reflex
- Plantar response
- Gross sensory testing
- Motor testing
- Dorsiflexion, eversion of foot
- Dorsiflexion of great toe
Nerve root L3 is testing what, and how to complete the test
M: extend quadriceps
F: squat up and down
Nerve root L4 is testing what, and how to complete the test
F: walk on toes
M: Dorsiflexion ankle
Nerve root L5 is testing what, and how to complete the test
F: walk on heels
M: Dorsiflexion great toe
Nerve root S1 is testing what, and how to complete the test
F: walk on toes
M: stand on toes (5 times)
Nerve root L3 is testing what sensory dermatome, and what reflex
S: lateral thigh and medial femoral condyle
R: patellar tendon
Nerve root L4 is testing what sensory dermatome, and what reflex
S: medial leg and medial ankle
R: patellar tendon
Nerve root L5 is testing what sensory dermatome, and what reflex
S: lateral leg and dorsum of foot
R: medial hamstring plantar response
Nerve root S1 is testing what sensory dermatome, and what reflex
S: sole of foot
R: Achilles tendon
