PT Implications For Neck And Back Pain

Question 1

DJD is most/least common to occur in what areas?

Answer 1

Most common: lumbar spine

Least common: thoracic spine

Question 2

What are the causes of DJD in 20y/o versus 30y/o?

Answer 2

20y/o: familiar/genetic, athletes

30y/o: macroscopic changes

Question 3

What is the predictable pattern for DJD?

Answer 3

Marked by significant changes in the nucleus polpouses

Dehydration, increase thickness, fibrosis, decreased shock absorption, tears AF, disc collapse, compression of vertebrate

Question 4

What are the risk factors for DJD?

Answer 4

Age, BMI, Genetics, psychosocial factors

Obesity: increases stress on discs
Smoking: impairs healing via vasoconstriction of vessels in response to nicotine
Arteriosclerosis: decreases circulation to spine if aorta is affected

Question 5

What age group is spinal stenosis most common in?

Answer 5

> 65 y/o

Question 6

What are the two types of LE spinal stenosis?

Answer 6

Neurogenic: radiating pain, parathesia, numbness)
Symptoms triggered via prolonged sitting (flexion) POSITION DEPENDENT

Vascular: TIME DEPENDENT
Related to the amount of time pt. Has been doing activity (i.e. Claudication)

Question 7

What is the most common site for spondlyolisthesis? Which gender does it often occur in and why?

Answer 7

L4-L5

Females because of larger facet joint angle

Question 8

What is the incidence and symptoms of cauda equina syndrome?

Answer 8

Rare: < 4/10,000

Saddle Anesthesia: Pain, numbness, tingling, parathesia in genital area
Pain in upper sacrum, bowel/bladder/sexual dysfunction

RED FLAG, SURGICAL EMERGENCY

Question 9

What is an ectopic pregnancy?

Answer 9

Pregnancy taking place in the tubes and not the uterus

Question 10

Red flags

Answer 10

Systemic: infection, diaphoresis, fatigue, dizziness 
Saddle anesthesia 
Decreased DTR
Constant pain, can't decrease symptoms 
No known MOI

Question 11

Yellow Flags

Answer 11

Decreased MMT
Symptoms beyond expected time frame
Difficulty describing pain